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POSTERIOR CRUCIATE LIGAMENT In world literature, it is often described as the primary knee stabilizer, however, its lesions, unlike those of the anterior cruciate ligament, can be healed by the human body itself, and are sometimes “underappreciated”. We are talking about the posterior cruciate ligament, which is stronger than the anterior one (it can withstand a force of 2,000 N), and its role is to restrain the posterior sliding of the tibia with respect to the thigh, while it is also “starring” as a horizontal axis during the knee rotation.

INJURY Injury, namely the discontinuation of the ligament, results from a direct backward collision of the tibia, with the knee being bent. It is considered a sports injury, but also an injury seen by orthopaedists after a traffic accident - the tibia is displaced by a force greater than the one which can be absorbed by the posterior cruciate ligament, despite the fact that it is “built to last”. In most cases, there are other concomitant ligament lesions, or lesions of either the meniscus, or the articular cartilage.

WHICH ARE THE SYMPTOMS? The symptoms include pain and swelling, already after the injury, stiffness and difficulty in walking, and, at the same time, knee instability. Although it can even lead to a severe disability, the damage to the posterior cruciate ligament has been underestimated – to this day, no comprehensive epidemiological studies are available. When joint injuries are more than one (for example, there is an instability and disruptions of multiple ligaments), then surgery is considered necessary. In each case, the doctor shall take several factors into consideration, including the age and level of activity, before suggesting a conservative or surgical treatment.

SURGICAL PROCEDURE AND POST-OPERATIVE COURSE The syndesmoplasty of the posterior cruciate ligament is performed arthroscopically, with small incisions, and an autograft from the patient themselves or an allograft (from the Achilles tendon) can be used for its reconstruction, depending on the simultaneous surgeries which shall be performed. The return to leisurely sports activities may take place within 3-4 months, while in sports such as football, a period of around 6 months is essential for recovery.

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