Posterior Cruciate Ligament (PCL) Repair

Pronounced: pos-tea-ree-or kru-shee-ate lig-a-ment

Definition

Posterior cruciate ligament (PCL) surgery is done to repair a torn ligament in the knee.

Posterior Cruciate Ligament
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Reasons for Procedure

This surgery is done when other methods have not helped. It may also be done in people whose PCL is no longer connected to the bone. The goal of surgery is to improve function and ease pain.

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Excess bleeding
  • Problems from anesthesia, such as wheezing or sore throat
  • Infection
  • Blood clots
  • Knee instability
  • Pain, numbness, or stiffness in the knee does not get better
  • The need for more surgery

Things that may raise the risk of problems are:

  • Smoking
  • Drinking
  • Chronic diseases, such as diabetes or obesity

What to Expect

Prior to Procedure

The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • The medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Fasting, such as avoiding food or drink after midnight the night before
  • Arranging a ride to and from surgery
  • Tests that will need to be done before surgery, such as images of the knee

Anesthesia

The doctor may give:

Description of Procedure

Small incisions will be made around the knee. Tools will be passed through the incisions. If enough of the ligament is intact, the damaged PCL may be reattached to the bone. Any tears in the ligament will be repaired.

If the PCL needs to be reconstructed, a tendon from another part of the body or a donor will be used. The remains of the damaged ligament will be cleaned away from the knee joint. Small incisions will be made in the thighbone and shinbone. The new tendon will be threaded through the incisions and held down with screws or staples. The incisions will be closed with stitches and covered with bandages.

How Long Will It Take?

How long it takes depends on the changes that need to be made. It may take up to 2 hours.

Will It Hurt?

Pain and swelling are common in the first few weeks. Medicine and home care can help.

Average Hospital Stay

You may be able to go home the same day. If you have problems, you may need to stay longer.

Post-procedure Care

At the Care Center

After the procedure, the staff may:

  • Give you pain medicine
  • Protect the knee with a splint or brace
  • Teach you how to use crutches

During your stay, staff will take steps to lower your chance of infection, such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

You can also lower your chance of infection by:

  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not letting others touch your incisions

At Home

It will take a few weeks for the incisions to heal. Full recovery can take 3 months. Physical activity will need to be limited at first. You will need to ask for help with daily activities and delay your return to work.

Call Your Doctor

Call your doctor if you are not getting better or you have:

  • Signs of infection, such as fever and chills
  • Redness, swelling, more pain, a lot of bleeding, or any leaking from the incision
  • Pain that you cannot control with medicine
  • Cough, shortness of breath, or chest pain
  • Nausea or vomiting
  • Numbness or tingling in the knee
  • New or worsening symptoms

If you think you have an emergency, call for medical help right away.

RESOURCES:

Ortho Info—American Academy of Orthopaedic Surgeons
http://orthoinfo.org

Sports Med—American Orthopaedic Society for Sports Medicine
http://www.sportsmed.org/Patient/Intro

CANADIAN RESOURCES:

Canadian Orthopaedic Association
http://www.coa-aco.org

Canadian Orthopaedic Foundation
http://www.canorth.org

REFERENCES:

Knee ligament repair. Johns Hopkins Medicine website. Available at: http://www.hopkinsmedicine.org/healthlibrary/test_procedures/orthopaedic/knee_ligament_repair_92,P07675. Accessed July 20, 2020.

Medial collateral ligament (MCL) injury of the knee. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/medial-collateral-ligament-mcl-injury-of-the-knee. Updated November 28, 2017. Accessed July 20, 2020.

Tandogan NR, Kayaalp A. Surgical treatment of medial knee ligament injuries: current indications and techniques. EFORT Open Rev. 2016 Feb;1(2):27-33.

Last reviewed March 2020 by EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM  Last Updated: 7/20/2020