What Is a Posterior Cruciate Ligament (PCL) Injury?
The posterior cruciate ligament (PCL) is one of the four major knee ligaments that stabilize the joint. Ligaments attach bone to bone, and the PCL is located in the center of the knee. It prevents the shin bone (tibia) from sliding backward relative to the thigh bone (femur) and limits twisting or pivoting motions.
A PCL injury usually occurs due to a direct contact injury—for example, during sports collisions or falls. It can also occur in combination with other knee ligament injuries such as an ACL tear or meniscus tear. These injuries are more common in teens and older athletes, and boys appear to be at slightly higher risk than girls.
Symptoms of a PCL Tear
- Feeling or hearing a “pop” in the knee at the time of injury
- Sharp pain that may improve over several weeks
- Swelling that develops within the first few hours after injury
- Sensation that the knee feels unstable or may “give out”
Diagnosis
A thorough physical exam by a pediatric orthopedic specialist often identifies a PCL tear. X-rays are used to rule out fractures, while an MRI helps confirm the diagnosis and check for other injuries—such as meniscus tears or damage to additional knee ligaments.
Treatment Options
Treatment depends on the severity of the tear and whether other structures in the knee are injured.
- Non-surgical treatment: For isolated PCL injuries, initial care focuses on reducing pain and swelling with ice, compression, and rest. Crutches and a brace (locked straight) help protect the knee and allow the ligament to heal. Physical therapy follows to restore motion, strength, and stability.
- Surgical treatment: If multiple ligaments are torn or if there is an associated meniscus tear, PCL reconstruction surgery may be recommended. During this procedure, an orthopedic surgeon reconstructs or replaces the ligament to restore stability. After surgery, patients typically wear a brace and complete about six months of physical therapy. Most young athletes can return to sports, though full recovery may take up to a year.
Expert Pediatric Knee Care at Rady Children’s
The Sports Medicine and Orthopedics team at Rady Children’s Hospital–San Diego is nationally recognized for treating PCL injuries and other complex knee ligament injuries, including both PCL and ACL tears. Our pediatric orthopedic surgeons specialize in precise surgical reconstruction techniques that restore knee stability, strength, and flexibility while minimizing recovery time. With expert physical therapy and ongoing follow-up care, we help each young athlete achieve the best possible outcome and return to the activities they love.