PCL Reconstruction
What is PCL Reconstruction?
PCL Reconstruction in Koramangala Bangalore is a surgical procedure performed to reconstruct an important knee ligament called the posterior cruciate ligament. The PCL is one of the major ligaments that crosses the back of the knee and connects the thigh bone to the shin bone. This ligament is less commonly injured compared to the anterior knee ligaments. The surgery is usually performed using minimally invasive arthroscopic techniques.
How does a PCL Injury Occur?
PCL injury may occur in the following situations:
- Direct blow to the shin just below the knee cap
- Falling on a bent knee
- Motor vehicle accident
- Contact sports
When is PCL Reconstruction Recommended?
PCL reconstruction may be recommended in cases of:
- Athletes who wish to return to sports
- Young or active individuals who maintain an active lifestyle
- Injury to multiple knee ligaments
- Dislocated knee joint
- Knee giving way frequently
What happens if a PCL injury is left untreated?
An untreated PCL tear can result in an unstable knee joint that gives way during physical activity, along with pain, swelling, and early arthritis.
Preparing for PCL Reconstruction
In preparation for surgery, you will receive specific instructions from Dr. Laxman. In general, you may be advised to:
- Perform exercises to strengthen the muscles around the knee and improve range of motion
- Inform Dr. Laxman about your current medications and allergies
- Undergo certain tests to ensure you are fit for surgery
- Follow Dr. Laxman’s instructions regarding medications and fasting before surgery
What happens during PCL Reconstruction?
The surgery is usually performed under spinal anaesthesia. The doctor often speaks with the patient during surgery, allowing you to decide whether you wish to remain awake or sleep through the procedure. Small keyhole incisions are made around the knee, through which an arthroscope and specialized surgical instruments are inserted. The arthroscope provides Dr. Laxman with a magnified view of the inside of the knee. Dr. Laxman prepares the damaged PCL and reconstructs it using a graft taken from a portion of healthy tendon from the patellar or hamstring region. Tunnels are created to position the graft accurately in its anatomical location, and it is secured using bio-screws, which usually dissolve within a year. Local anaesthetic may be infiltrated at the end of the procedure to help control post-surgical pain. A surgical dressing is applied to protect the incision site.
Recovery after PCL Reconstruction
Following arthroscopic PCL Reconstruction in Sarjapur Road Bangalore, most patients can return home on the same day or after an overnight stay. Medications are prescribed to control post-surgical pain and swelling. The use of crutches and a knee brace may be required for a few days after surgery. You will receive instructions on incision care and daily physiotherapy exercises to help speed up recovery.
FAQs
How soon can I have surgery for a torn PCL?
In most cases, the ideal time for reconstructive surgery is 2–3 weeks after the injury. This is before muscle wasting and knee stiffness develop, allowing for faster recovery. During this period, physiotherapy and rehabilitation, known as pre-habilitation, are recommended. Dr. Rewat prescribes an individualized pre-hab protocol for each patient.
Can I delay surgery for a PCL tear?
PCL reconstruction is not an emergency procedure and can usually be delayed to accommodate work or personal commitments. During this time, sports and activities involving sudden changes in direction should be avoided. Ongoing physiotherapy is important.
If there are associated injuries such as a meniscal tear that may be suitable for repair, surgery may be recommended sooner.
Can a PCL tear heal?
In most cases, posterior cruciate ligament tears are complete tears, and the ligament has limited capacity to heal. This is partly because the tear occurs within the knee joint, which contains joint fluid that interferes with healing.
In some cases, limited healing may occur and provide partial stability. However, the ligament may heal in an elongated position, which can still result in knee instability.
What happens if I don’t have a PCL reconstruction?
The posterior cruciate ligament is important for knee stability, especially during twisting, turning, and directional changes. After a PCL tear, pain may settle, but instability often remains. Many patients are unable to return to competitive sports without reconstruction.
An unstable knee is also more likely to develop arthritis in the long term, although this does not occur in all patients.
What type of graft should I have for my PCL reconstruction?
Several graft options are available, with hamstring tendon grafts being the most commonly used. Although graft choice is important, it is not the only factor determining surgical success.
Dr. Rewat may recommend the following grafts:
- Bone-Patellar Tendon-Bone graft
- Hamstring graft
- Peroneus longus graft
All these grafts are autografts, and the pros and cons of each option will be explained in detail.
How long do you have to be on crutches after PCL surgery?
Most patients use a walker for about 2 weeks while partially bearing weight on the operated leg. Full weight-bearing without crutches is usually possible after 4 weeks.
How long do you need a brace after PCL reconstruction?
Dr. Rewat advises wearing a long knee brace for 2 weeks, followed by a hinged knee brace for an additional 4 weeks.
What rehabilitation will I need after PCL reconstruction?
Physiotherapy is essential after PCL reconstruction. A physiotherapist will guide your recovery and teach exercises to be performed for 20–30 minutes, three times a day during the first six weeks.
When can you start driving after PCL surgery?
You should avoid driving for at least 6 weeks after surgery. Driving an automatic car may be possible after this period, provided you can safely control the vehicle and stand on one leg for 2 minutes.
How soon can you return to work after PCL surgery?
Office work can usually be resumed after one week. Light physical duties may begin after 6 weeks, while manual labor is typically postponed until around 12 weeks after surgery.
Jobs involving ladders, scaffolding, or roofs should be avoided for at least 4 months after surgery.
When can I play sport after PCL reconstruction?
Swimming and exercise biking can usually begin around 6 weeks after surgery. Jogging typically starts at 10–12 weeks.
Return to competitive sports and activities involving twisting and turning is usually allowed after 7–9 months.