OVERVIEW
The posterior cruciate ligament is located at the back of the knee joint and acts as a “bridle”, protecting and holding the joint, and restricting the backward movement of the tibia, in relation to the thigh. It is more “rigid” than the anterior cruciate ligament and consists of two bundles: the stronger and thicker one is called anterolateral and has an active involvement in the knee flexion, while the smaller bundle is the posteromedial one, which is activated when the knee is extended.

WHICH ARE THE SYMPTOMS?
Injury to the posterior cruciate ligament is less common, however, when a tear occurs, it means that a significant force has been applied, as happens in a car accident, when a flexed knee collides onto the dashboard or during a game, when the footballer falls upon the bent knee. This tear is usually accompanied by other lesions: meniscus tears, tears of the medial collateral or the lateral collateral ligament, or the anterior cruciate ligament may coexist. This is why the damage is difficult to evaluate and is often “confused” with other knee injuries.
According to the American Academy of Orthopaedic Surgeons, the injury is classified into three stages, depending on whether the ligament is simply stretched, or if it has been partially or totally ruptured and torn into two pieces.

WHICH IS THE BEST TREATMENT?
An arthroscopy is performed in patients with a total tear of the posterior cruciate ligament, or with concomitant ligament tears of the knee. Regarding syndesmoplasty, namely, the reconstruction of the ligament, grafts (either autografts - obtained from the patient themselves, usually from the patellar tendon or the hamstring - or allografts) are used to restore joint stability and reduce the risk of premature degeneration (osteoarthritis).

Για την αρθροσκόπηση γίνονται δύο μικρές τομές ενώ από μία τρίτη μήκους 2-3 εκ. λαμβάνεται το μόσχευμα. Η καθήλωσή του γίνεται στα δύο οστικά κανάλια, το μηριαίο και το κνημιαίο, με βιοαπορροφήσιμα υλικά.

During the arthroscopy procedure, two small incisions are made, while the graft is obtained through a smaller one, with a length 2-3 cm. Its fixation is performed onto the two bone canals, the femoral and the tibial one, with bioabsorbable materials.
Postoperatively, a physiotherapy programme is followed, in order for the patient to regain the strength and motion of the knee. The return to day-to-day activities and physical exercise depends on the severity of the injury; the more lesions, the slower the recovery. Thus, after arthroscopy, the period required to return to sporting activities ranges from 6 to 12 months.

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