Isolated posterior cruciate ligament injuries

Isolated posterior cruciate ligament (PCL) injuries are rare but PCL injuries commonly occur as part of multiligament knee injuries. PCL is the largest ligament in the knee and has two main bundles: anterolateral and posteromedial. These two bundles are thought to work in a co-dominant relationship to provide restraint/stability to posterior tibial translation. The PCL also has good capacity to heal following an injury. Majority of isolated PCL injuries can be treated non-operatively with rehabilitation focusing on prevention of posterior tibial sag, progressive weight bearing, prone range of movement exercises and quadriceps strengthening. PCL reconstructions are undertaken in chronic injury with persistent symptoms, failure of non-operative treatment and combined multiligament knee injuries. Common PCL reconstruction techniques include single bundle vs. double bundle and transtibial vs. tibial inlay. There is controversy on which reconstructive method is best.