Question

I'm uma, 25 age. I diagnosed with pcl buckling. Please do suggest me what should I do to avoid surgery.
Technique sequences pdfs, sag, coronal t2 axials
findings
⚫ medial meniscus - there is thinning of medial meniscus with grade ii tear its posterior horn.
• lateral meniscus grade ii tear of posterior horn of lateral meniscus. • anterior cruciate ligament - there is complete tear of acl with clumping
fibres in intercondylar fossa. • posterior cruciate ligament - buckling of pcl.
⚫ medial collateral ligament - grade ii sprain of mcl. • posture-lateral corner
grade I sprain of arcuate ligament.
Popliteal muscle - normal
-popliteo-fibular ligament - normal
-popliteo-fibular ligament complex - normal
short & long head of tendons of biceps femoris- normal - menisci-popliteal fascicles - normal,
- lateral collateral ligament - grade ii sprain of lcl.
• quadriceps tendon and patellar ligament - normal. • patella and patellar cartilage - normal.
There is medial tibial-femoral joint space reduction with thinning of cartila muscles around knee - normal.
Loose bodies-absent
⚫ contusions noted in posterior cortex of tibia. Mild joint effusion & suprapatellar effusion.
Impression:
• chronic complete tear of anterior cruciate ligament with clumping of fibres in intercondylar fossa.
• grade ii tear of posterior horn of lateral meniscus.
Thinning of medial meniscus with grade ii tear of its posterior horn.
• grade ii sprain of medial collateral ligament.
posture-lateral corner injuries as described.
Mild joint effusion & suprapatellar effusion.
Suggested clinical correlation and further evaluation.

Dr.Julie Mercy J David · Accepted Answer

The typical symptoms of a posterior cruciate ligament injury are:
•pain with swelling that occurs steadily and quickly after the injury.
•swelling that makes the knee stiff and may cause a limp.
•difficulty walking.
•the knee feels unstable, like it may "give out"
the posterior cruciate ligament (pcl) is the strongest ligament in the knee. It extends from the top-rear surface of the tibia (bone between the knee and ankle) to the bottom-front surface of the femur (bone that extends from the pelvis to the knee).
Can you walk with a pcl injury? It depends. In mild cases, people may still be able to walk and their symptoms may be less noticeable. However, many people have difficulty walking after a pcl injury — especially if the damage is severe. 1
pcl injuries are usually partial ligament tears, and typically heal on their own, without causing stability issues, so long as the knee is protected during healing, and there are no other knee joint injuries
treatment
1.Rest the joint to prevent further injury.
2.Ice the injured area to reduce swelling.
3.Compress the joint with an elastic bandage.
4.Elevate the leg when at rest.
Around 9 weeks post-injury, the patient can initiate a light running program and gradually return to sports activities through week 12. Criteria to return to sport: absence of pain and swelling. No detectable laxity within the injured knee.
 
many grade I and grade ii injuries will not require pcl surgery. Surgery is often recommended when there is a complete tear of the pcl, if there is also damage to surrounding ligaments, or if the knee has become dangerously unstable.
The pain from an acl tear usually will be more severe than that of a pcl tear. There also may be significant (or total) loss of range of motion of the knee. Swelling from an acl tear tends to develop slowly, over the course of 24 hours.
The pcl is broader and stronger than the acl and has a tensile strength of 2000 n. Injury most often occurs when a force is applied to the anterior aspect of the proximal tibia when the knee is flexed. Hyperextension and rotational or varus/valgus stress mechanisms also may be responsible for pcl tears.
How can I strengthen my knee after pcl tear?
Knee flexion with heel slide
1.Lie on your back with your knees bent.
2.Slide your heel back by bending your affected knee as far as you can. Then hook your other foot around your ankle to help pull your heel even farther back.
3.Hold for about 6 seconds, then rest for up to 10 seconds.
4.Repeat 8 to 12 times.
The pcl heals without surgery
key results from two studies show that: isolated pcl tears heal without surgery. Some laxity does not reduce activity, strength or range of motion. The incidence of moderate to severe osteoarthritis is the same for non-operative treatment and pcl reconstruction. How do you treat a pcl injury?
Immediate treatment for pcl injuries includes the following:
1.Applying ice to reduce swelling.
2.Elevating your knee to reduce swelling.
3.Placing the knee in a splint to limit movement.
4.Taking nonsteroidal anti-inflammatory drugs (nsaids) to ease pain and swelling.
5.Compressing your knee using an elastic bandage or brace.
If enough of the ligament is intact, the damaged pcl may be reattached to the bone. Any tears in the ligament will be repaired. If the pcl needs to be reconstructed, a tendon from another part of the body or a donor will be used. The remains of the damaged ligament will be cleaned away from the knee joint.

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