How Is a Posterior Cruciate Ligament Tear Treated?

If your posterior cruciate ligament (PCL) tear is mild, our knee surgeon, Dr. Charles Ruotolo, may recommend rest, bracing, NSAIDs, and activity modification to reduce pain. However, if your PCL tear is severe or causes ongoing knee instability, he may recommend surgery to reconstruct the damaged ligament and restore knee function.

After your treatment, our team at Total Orthopedics & Sports Medicine closely monitors your recovery and guides you through each stage of healing to help improve knee strength. We also offer follow-up appointments to assess your range of motion, check the surgical site, and ensure your knee is healing properly. Call us today at 855-321-6784 to book your appointment with Dr. Charles Ruotolo in Commack.

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What Treatment Works Best for a PCL Tear?

Depending on your PCL tear grade, rest, ice therapy, bracing, NSAIDs, hyaluronic acid injections, activity modification, corticosteroid injections, or surgery can help restore your knee function. For instance, if you have a mild Grade I PCL tear, you may need non-surgical treatments, such as HA injections, pain medication, or steroid injections.

For Grade II tears, our orthopedic knee specialist, Dr. Charles Ruotolo, may recommend quadriceps strengthening exercises, custom knee bracing, or temporary activity restrictions. On the other hand, severe Grade III tears that cause significant knee instability may require surgery to relieve pain. Here’s how these treatments can help restore your knee function and ligament strength:

Rest and Ice Therapy

Rest is the initial treatment after a PCL injury and helps reduce stress on the injured ligament. It can also reduce swelling and inflammation around the joint, making it easier to manage pain in the early stages of recovery. Similarly, ice therapy can numb the affected area, decrease swelling, and reduce knee pain. Here’s how you can effectively use ice therapy after a knee ligament injury:

• Apply ice within the first 24–48 hours after injury to help control early swelling.
• Use a cold compress or ice wrapped in a thin towel (never place ice directly on skin)
• Apply for 15–20 minutes at a time to avoid skin irritation or damage.
• Repeat every 2–3 hours during the day in the early recovery phase.
• Keep the knee elevated while icing to help reduce swelling more effectively.
• Stop if numbness or skin irritation occurs to avoid discomfort.

Knee Bracing

Bracing can stabilize your knee and limit excessive tibial movement after a PCL tear. It can also reduce pressure on the damaged ligament during walking and daily activities, such as:

• Climbing stairs.
• Standing for long periods.
• Getting in and out of a car.
• Walking on uneven surfaces.
• Bending or squatting.
• Light daily movement around your home or workplace.

Pain Medication

NSAIDs, such as ibuprofen or naproxen, help reduce inflammation and relieve knee pain caused by chronic PCL injuries. These medications may also decrease swelling around the ligament and surrounding soft tissues. Similarly, acetaminophen (paracetamol) can help reduce pain and improve comfort without directly targeting inflammation. However, you should avoid taking NSAIDs for long periods, as excessive use of these medications may lead to side effects, including:

• Stomach irritation or ulcers.
• Acid reflux or heartburn.
• Kidney problems.
• Increased blood pressure.
• Liver damage from excessive acetaminophen use.
• Higher risk of bleeding or bruising.
• Fluid retention or swelling.

Hyaluronic Acid (HA) Injections

HA injections may help improve knee joint lubrication and reduce discomfort after a PCL injury. These injections are commonly used when you have constant knee stiffness, cartilage wear, or early-stage knee osteoarthritis after ligament damage. In fact, according to a NCBI review, hyaluronic acid (HA) may help stimulate proteoglycan and glycosaminoglycan production in the knee, which are important for maintaining healthy cartilage.

Corticosteroid Injections

Corticosteroid injections can reduce inflammation and relieve knee pain after a posterior cruciate ligament (PCL) injury. These injections deliver a strong anti-inflammatory medication directly into the knee joint, helping reduce swelling in the surrounding soft tissues.

However, repeated corticosteroid injections over time may weaken nearby tissues, affect cartilage health, or increase the risk of joint damage. Therefore, doctors usually recommend limited use of cortisone injections. For example, according to OrthoInfo, many medical providers set a practical limit of three to four cortisone shots per year.

Activity Modification

After a PCL injury, you should temporarily avoid activities that place excessive stress on your knee joint. These activities may include running, jumping, heavy lifting, deep squatting, contact sports, and sudden twisting movements. In some cases, our orthopedic surgeon, Dr. Charles Ruotolo, may also recommend the following activity restrictions after ligament injury:

• Kneeling on hard surfaces.
• Walking long distances without support.
• Walking on uneven or unstable ground.
• Carrying heavy loads or backpacks.

Knee Surgery

If non-surgical treatments do not provide enough pain relief or improve your knee stability, our surgeon may recommend knee surgery. Surgical treatment is often recommended for severe Grade 3 PCL tears or injuries involving multiple ligaments (anterior cruciate ligament and other ligament injuries). In such cases, surgical intervention can restore knee stability, improve joint function, and reduce ongoing pain during movement. PCL surgery may also improve balance and support better knee strength during daily activities.

Who Is at Risk for a Posterior Cruciate Ligament Injury?

Posterior Cruciate Ligament (PCL) injuries typically affect athletes in high-impact or contact sports and individuals involved in vehicular accidents. Workers in physically demanding jobs that require heavy lifting, climbing, or repetitive knee stress are also at high risk of PCL injuries. Besides that, certain differences in knee anatomy may increase the risk of ligament injury.

In fact, a NIH study found that females with a larger coronal notch width index had a greater risk of PCL injury. In males, a smaller coronal femoral condylar width was identified as a major risk factor for ligament rupture. Moreover, the following individuals may have a higher risk of knee ligament injuries:

Older Adults

As you age, ligaments and surrounding knee structures gradually lose strength and elasticity. This reduced strength can make your knee unstable during everyday activities. It can also increase the risk of falls, which may directly lead to a posterior cruciate ligament (PCL) injury. Additionally, age-related muscle weakness in the quadriceps and hamstrings can reduce joint support, increasing stress on the ligament during movement. These factors make older adults more prone to PCL injuries and related knee complications, such as:

• Chronic knee pain.
• Knee stiffness.
• Reduced range of motion.
• Balance problems.
• Joint instability.
• Cartilage wear and degeneration.

Skiers

In skiing, the posterior cruciate ligament (PCL) is at risk of injury due to sudden falls, twists, and direct impact to the knee. High-speed downhill skiing can also put significant pressure on the knee joint during sudden stops or landings. In such cases, your shin bone may forcefully move backward, putting excessive stress on the PCL and surrounding knee structures. This pressure can stretch the knee ligament, leading to single or multi-ligament knee injuries.

Rugby Players

Rugby players have a high risk of posterior cruciate ligament (PCL) injuries due to frequent tackles, collisions, and direct blows to the knee. Sudden twisting movements, rapid direction changes, and high-impact contact can also strain the knee joint and surrounding ligaments. According to a long-term NIH study of professional male rugby players, the match-knee injury rate was 9.8 injuries per 1000 match hours.

Is PRP Therapy Effective for a PCL Tear?

Yes, Platelet-Rich Plasma (PRP) therapy can be highly effective for partial and Grade I PCL damage and isolated PCL tears. In this treatment, doctors draw a small amount of your blood and process it in a centrifuge to concentrate platelets rich in growth factors. Then, these concentrated platelets are injected into the injured knee ligament. This process helps stimulate the body’s natural healing response, reduce inflammation, and support tissue repair in the PCL-deficient knee.

However, PRP alone cannot fully restore knee stability or repair ligament tears. Therefore, our knee surgeon, Dr. Charles Ruotolo, may combine PRP therapy with bracing, activity modification, and exercises to support ligament healing. In one PubMed study, researchers evaluated 7 amateur athletes with PCL injuries and found that patients treated with PRP injections started rehabilitation earlier than those treated with conservative care alone.

What Type of Knee Brace Helps a Torn PCL?

Dynamic PCL braces, hinged functional braces, and rehabilitative braces can help support and stabilize your knee after a posterior cruciate ligament (PCL) tear. Similarly, post-surgical braces, hinged knee braces, and unloader braces can help reduce pressure on the injured ligament. Here’s how these braces can limit excessive movement and support your knee after a knee injury:

• Dynamic PCL Braces: Apply constant forward pressure to avoid backward motion and reduce stress on the PCL.
• Hinged Functional Braces: Improve knee stability during walking and allow controlled knee movement during daily activities.
• Rehabilitative Braces: Limit excessive knee motion after injury or surgery to protect the healing ligament.
• Post-Surgical Braces: Keep the knee in a controlled position after surgery and reduce strain on repaired tissues.
• Hinged Knee Braces: Support side-to-side posterior stability and reduce abnormal joint movement during physical activity.
• Unloader Braces: Shift pressure away from the injured part of the knee joint to improve comfort and reduce stress on the ligament.

At Total Orthopedics & Sports Medicine, our knee surgeon, Dr. Charles Ruotolo, carefully evaluates imaging tests (magnetic resonance imaging and X-rays) and injury patterns to choose the right knee
brace for your condition. This personalized approach helps ensure you receive the proper knee support to reduce pain and protect your ligaments during recovery.

Moreover, to make your treatment experience easier, we accept a wide range of insurance plans and offer transparent self-pay pricing with flexible payment options for patients without coverage. Our team also explains your coverage details, referrals, and co-pays while handling the necessary paperwork, so you can focus on your recovery. Call us today at 855-321-6784 to book your appointment.

How Does a PCL Tear, ACL Injury, and Meniscus Tear Differ?

In PCL tears, the ligament that controls backward movement of the shin bone gets damaged, while in ACL injuries, the ligament responsible for forward knee stability ruptures due to sudden twisting. On the other hand, a meniscus tear affects the cartilage that cushions and stabilizes the knee joint. Here’s a comparison of PCL vs ACL vs meniscus injuries based on the common causes and symptoms:

Injury Type	Cause and Symptoms
PCL Tear	Direct knee impact leading to instability and pain
ACL Injury	Rapid direction changes resulting in knee buckling
Meniscus Tear	Knee twisting that may cause locking and stiffness

When Is Surgery Recommended for a PCL Tear?

Our surgeon, Dr. Charles Ruotolo, may recommend surgery for a posterior cruciate ligament (PCL) tear if the injury is severe or does not improve with non-surgical treatment. He may also recommend surgery for complete (Grade III) tears, displaced bone avulsion fractures, or chronic tears. In some cases, surgery may be necessary if your knee repeatedly buckles, feels unstable during movement, or limits your ability to perform daily activities. Here are some additional PCL symptoms that may require surgical intervention:

• Numbness or Tingling: Reduced sensation below the knee may indicate nerve involvement after a severe ligament injury.
• Lateral Meniscus Damage: Tears in the lateral meniscus may worsen knee instability and increase stress on the four major ligaments (ACL, PCL, MCL, and LCL).
• Visible Knee Deformity: Changes in knee shape after trauma may indicate major ligament or structural damage around the joint.
• Bone Bruises: Severe impact injuries can cause bone bruises between the thigh bone and the medial tibial plateau, increasing the risk of ligament damage.
• Internal Rotation Instability: Excessive internal rotation of the knee joint can increase pressure on the PCL and surrounding structures.
• Knee Locking or Catching: Sudden locking sensations may occur when damaged tissues interfere with normal joint movement.
• Proximal Tibia Injury: Damage near the proximal tibia may affect knee alignment and increase ligament instability.

How Does Reconstruction Surgery Fix a Torn PCL?

In PCL reconstruction surgery, the surgeons first make small incisions around your knee and insert an arthroscope to visualize the damaged PCL. Then, they remove the torn PCL tissue and prepare precise bone tunnels in the tibia and femur. After that, the surgeon places a tendon graft through these tunnels to replace the torn ligament. This tendon graft is usually extracted from your own body or from a donor.

Once extracted, the surgeon carefully positions the tendon graft within the prepared bone tunnels to restore the original PCL’s function. Then, fixation devices, such as screws or buttons, secure the graft in place to stabilize the knee joint. After fixation, the surgeon checks knee movement and graft tension to ensure proper alignment and stability. Over time, the PCL graft gradually heals and attaches to the surrounding bone and soft tissues through a process called “graft incorporation”. This healing process helps restore knee strength, joint stability, and normal movement after severe ligament damage.

Which Strengthening Exercises Help After a PCL Tear?

Quadriceps sets, straight leg raises, hamstring curls (light resistance), and heel slides can help improve knee strength after a PCL tear. Mini squats, Stationary cycling, and step-ups (low step) can also improve knee balance. Here’s how you can perform these exercises after a ligament tear to support healing:

• Quadriceps sets: Sit or lie with leg straight, tighten thigh muscle, hold 5–10 seconds, then relax.
• Straight leg raises: Lie flat, keep knee straight, lift leg 12–18 inches, lower slowly.
• Hamstring curls (light resistance): Stand or lie face down, bend the knee slowly toward the buttocks, then return.
• Heel slides: Lie down, slowly slide heel toward buttocks, then straighten leg again.
• Mini squats: Stand with support, bend knees slightly (not deep), then return to the standing position.
• Stationary cycling: Use low resistance, pedal slowly with smooth, controlled motion.
• Step-ups (low step): Step onto a low platform, lift your body up, then step down slowly.

How Long Does It Take To Recover from a PCL Injury?

After a PCL injury, full recovery usually takes about 1-3 weeks for mild Grade I–II tears. But more severe Grade III tears or surgical cases may take 6 to 12 months, depending on healing progress and knee stability. However, the exact recovery timeline may vary depending on the following factors:

• Severity of the PCL tear.
• Presence of other ligament or meniscus injuries.
• Type of treatment (non-surgical vs surgical)
• Age and overall health condition.
• Muscle strength around the knee.
• Consistency of follow-up care and monitoring.

Visit Total Orthopedics & Sports Medicine for PCL Tear Treatment in Commack!

After a posterior cruciate ligament (PCL) tear, you may experience knee pain, swelling, and knee instability, especially when walking downhill, going downstairs, or bending the knee. If left untreated, these symptoms can worsen and lead to meniscus damage, gait problems, and early knee osteoarthritis.

As a member of the Alpha Omega Alpha Honor Medical Society, our surgeon, Dr. Charles Ruotolo at Total Orthopedics & Sports Medicine, has extensive experience treating PCL tears and other complex knee ligament injuries. He designs personalized treatment plans to restore your knee stability, reduce pain, and improve overall joint function. Call us today at 855-321-6784 or visit us at 500 Commack Road, Bldg E, Suite 150B, Commack, NY 11725 to book your appointment.

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