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ACL (anterior cruciate ligament) and PCL (posterior cruciate ligament) tears are common knee injuries, especially for athletes and sometimes after road traffic accidents. The ACL and PCL are two of four ligaments that stabilize the knee joint, allowing the knee to move forward and backward without moving side to side. The ACL is located in the center of the knee just in front of the PCL, keeping the shin bone (tibia) from moving too far forward, while the PCL keeps it from moving too far backward. The ligaments cross over each other, and along with the MCL and LCL, work to stabilize the knee joint. Injuries to these ligaments are more often sprains than tears, although partial or full tears can occur to either ligament.
ACL and PCL sprains and tears can occur when the knee joint twists abruptly and forcefully while the feet remain planted on the ground. In addition to sudden twisting of the knee, ACL injuries can also occur when an individual changes direction, pivots, slow down suddenly, or misses the landing of a jump. PCL injuries, on the other hand, are more likely to occur when the front of the knee sustains a sudden and forceful impact or when the knee is hyper-extended. ACL injuries are often the result of involvement in sports and don’t require physical contact, while a PCL injury is more likely the result of forceful contact or a collision.
When an ACL or PCL tear occurs, an individual will typically experience severe pain and swelling. Individuals will have decreased motion or instability in their knee joints. Most tears result in a “popping” sound and the feeling that the knee has given out.
ACL and PCL tears are diagnosed following a physical assessment of the knee joint, including feeling the area for swelling and testing mobility and flexibility of the joint by moving the leg in various positions. A medical professional will also ask how the injury occurred in order to gain a better understanding of what type of movement may have caused the injury, which can help determine which ligament is damaged. X-rays and MRIs will be used to determine the severity of the injury and to see if other ligaments or cartilage are injured as well.
If you experience pain or swelling in your knee that does not go away following a period of rest, ice or over-the-counter pain medication, it is best to have your knee evaluated by a medical professional. If you have sustained an injury in which you hear a “popping” sound or your knee has given out on you and you continue to experience instability or decreased motion, you should also seek medical advice. There are many knee injuries that can occur, and determining the exact injury or cause of pain will be helpful in choosing the best treatment method to alleviate pain, restore motion and flexibility, and reduce the chance that further damage or re-injury will occur.
The treatment for ACL and PCL tears will depend in part on the extent of the damage and the activities you typically perform. If you do not require these ligaments to be fully functioning, do not experience excessive pain or instability, and have not fully torn the ligaments, surgery may not be required. Some patients with partial tears will begin to recover after a few weeks of rest followed by rehabilitation to strengthen the knee. Surgery may be necessary if the ligament is fully torn, you experience a lot of pain and instability, or you require a fully functioning ligament in order to maintain your current activity level (such as athletes). ACL surgery is more common than PCL surgery and surgery for both ligaments requires reconstruction of the torn ligament, rather than repair of the existing ligament. Rehabilitation is crucial following surgery in order to achieve a full recovery and recovery following surgery can be lengthy. wearing a knee brace is helpful in improving knee stability during activity following injury and can help prevent re-injury.
Some patients with ACL and PCL injuries will begin to feel better following a short period of rest followed by rehabilitation to strengthen the surrounding knee joint and muscles. If the ligaments are only partially torn, pain may subside although some instability may remain and regular athletic activity levels may not be able to be performed. ACL surgery is often successful if a proper rehabilitation program is followed after surgery. In some instances, braces may need to be worn on the knee to increase knee stability following an injury. Recovery following an ACL or PCL tear will typically allow individuals to maintain everyday activity levels, but the injury may impact participation in competitive sports (as is seen in some professional athletes).
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