What is Posterior Cruciate Ligament Reconstruction?
The posterior cruciate ligament (PCL) is one of the two large
ligaments within the knee. It controls front to back
movement. The PCL can be torn or ruptured during sports
activities or from a direct blow to the knee. Once broken, it
may heal but is usually a longer length than normal. This can
cause the knee to give way, but more usually causes pain and in the
longer term, osteoarthritis or wear of the knee.
Minor or moderate lengthening of the PCL is treated by
physiotherapy or muscle strengthening. A severe injury of the
PCL will require reconstructive surgery.
A ligament graft is required using material taken from the front
of the knee or from the hamstring tendons behind the knee, both of
which are able to re-grow to a large extent.
Once fixed in the knee the graft is able to form a new
ligament. This process takes up to a year but you would
normally be able to return to sports activity after six months.
What does this involve?
Posterior cruciate ligament reconstruction is usually performed
through keyhole surgery under general anaesthetic. You would
normally be admitted on the day of the operation and have an
overnight stay in hospital.
You will not be able to eat for eight hours prior to surgery
although you will be able to drink small amounts of water up to
four hours before.
The operation takes about one hour and your Surgeon will make
some incisions in your knee to allow small specially designed
instruments to be introduced. The torn ligaments are trimmed
and the knee is prepared for the replacement graft. The top
and bottom ends of the replacement ligament are fixed into place
with special screws into holes drilled into your bones.
The incisions are closed with stitches or adhesive strips
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When will I recover?
Recovery from the anaesthetic is rapid and you will be awake
very soon after the operation although you may feel drowsy for an
hour or two. You will be allowed to go home once you are
weight bearing with the assistance of crutches, if necessary, for
security.
You may shower with the waterproof dressing on and your
Physiotherapists will give you on how to exercise your leg before
you leave and may arrange outpatient physiotherapy if needed.
You will be given a cold compress or 'Cryocuff' along with
instructions on how to cool your knee, which is important and aids
recovery. Your will be in a knee brace or sometimes a plaster
cast and you will see your Consultant once again two weeks after
your operation to review your progress.
You may need to take 4-6 seeks off work and driving following
the operation and rehabilitation following a PCL reconstruction is
extensive. You will require physiotherapy once a week for
two-three months and less frequently up to nine months.
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What risks should I know about?
Posterior cruciate ligament reconstruction is commonly preformed
and generally safe but there are some potential complications you
should be aware of. These only affect less than 4% of
patients.
- Infection can occur although our theatres have ultra-clean air
operating conditions keeping infection rates at 1-2%.
- Blood clots are possible but again are in the 1-4% category and
have well established treatments including aspirin.
- A small patch of numb skin can be present on the outer part of
the knee near the kneecap, this will improve over time
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Circle care
Knee surgery is carried out in our Knee Unit at CircleBath where
specialist knee surgeons have created a centre of excellence.
You can be sure of state of the art facilities and the best
possible care to get you back to normal as soon as possible.
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