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305 Nakodar Chowk,Lajpat Nagar, JalandharThe bones in the knee (the thighbone and the legbone) are tied together by straps – called ligaments. Two important ligaments inside the knee are called ‘cruciates’ – because they form a cross. The one in front is called the Anterior Cruciate Ligament (ACL) and the one behind is called the Posterior Cruciate Ligament (PCL). Both are very important for knee function.
The Posterior Cruciate Ligament (PCL) can tear only after a vigorous injury to knee from:
Motor vehicle accidents - typically a "dashboard injury" occurs when the driver's or passenger's bent knee slams against the dashboard.
Contact sports - like football, rugby, kabaddi can also damage the PCL following a fall on the bent knee.
Awkward fall - fall from height or an awkward heavy fall can also damage the PCL.
Following an acute injury to the PCL there will be severe pain and swelling. The pain is usually in the back of the knee, and in some cases there may be bruising. Patients have difficulty in walking, and in more severe cases, the knee feels unstable ("giving way").
Later, there is persistent knee pain, weakness, instability and loss of balance. Often there is difficulty in climbing stairs or sitting on floor. Running, jumping, squatting and playing sports progressively becomes difficult.
It depends on your disability and your activities. In brief, if you are engaged in lots of outdoor activities and heavy work and not willing to restrict your activities then you need an operation to make (reconstruct) a new ligament. This applies to the most young and active people.
However, if you have minimum symptoms and have a sedentary lifestyle then you can manage with exercise, knee-support and some activity restrictions for the rest of the life. Generally, this is applicable to elderly persons.
The operation is done under general or regional anaesthesia. At first, the inside of the knee is examined by a thin telescope which is introduced through a small puncture (arthroscopy). Next, a new ligament is prepared by taking a few fibers from the tendons around the knee. Generally, the hamstring tendons from the back (or less commonly the patellar tendon from the front) are used.
This newly fashioned ligament is then placed inside the knee through the arthroscope which grows and matures to take up the function of the original ligament.
Other than the disabilities like giving-way, pain, swelling, etc., it is said to be the ‘beginning of the end’ of the knee. The knee suffers repeated injuries because of its undue laxity and early arthritis sets in.