PCL Injuries Surgical Treatment

What are the surgical treatment options for a PCL injury?

For patients with combined ligamentous injury,  chronic cases, or those that remain symptomatic despite the conservative treatment, surgery is recommended. PCL surgery is similar to ACL surgery in that it involves drilling tunnels into your tibia and femur before fixing a graft into those tunnels. However, because the PCL is bigger than the ACL, it typically requires two grafts to truly replicate the anatomy and biomechanics. An Achilles tendon allograft and a hamstring tendon allograft are the two most often used grafts for the double-bundle PCL reconstruction gold-standard technique.

Although a more challenging technique, substantial evidence suggests that the double bundle technique (two grafts) is superior in terms of knee function and stability compared to a single bundle PCL reconstruction. Recall that the PCL has two bundles: the anterolateral bundle and the posteromedial bundle. The anterolateral bundle prevents excessive front-to-back motion of the tibia, while the posteromedial bundle prevents excessive rotation of the tibia. Thus, as the two bundles have different primary functions, it is necessary to reconstruct both bundles when the PCL is torn.