Anterior and Posterior Cruciate Ligament (ACL & PCL) Repair
Case Definition
The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) are among the most important ligaments responsible for knee joint stability.
Injuries to these ligaments commonly occur due to intense sports movements such as jumping, rapid twisting, or strong collisions.
In cases of complete rupture or functional failure, surgical repair or reconstruction of the cruciate ligament is performed using grafts taken from the patient’s own body or synthetic grafts.
Symptoms:
- Sudden sharp pain at the moment of injury.
- Hearing a “popping” sound inside the knee.
- Rapid swelling within hours.
- A feeling that the knee is “giving way” or unable to bear weight.
- Difficulty bending or fully extending the knee.
- In PCL injuries: pain when climbing stairs or walking backward.
Diagnosis:
- Specialized clinical examination (Lachman test – posterior drawer test).
- X-ray imaging to rule out fractures.
- MRI to confirm the type of tear and determine whether it is partial or complete.
- In some cases, diagnostic arthroscopy is used to assess associated injuries (meniscus or other ligaments).
Treatment Methods:
In cases of partial tear:
- Conservative treatment (physical therapy, muscle strengthening, knee brace).
In cases of complete tear:
- Cruciate ligament reconstruction surgery (ACL or PCL) using:
- Patellar tendon graft or hamstring tendon graft.
- Internal fixation with screws or biological fixation devices.
- The procedure is usually performed arthroscopically, which minimizes incisions and speeds up recovery.
When is surgery recommended?
- If the tear is complete.
- Clear loss of knee stability during movement.
- Failure of conservative treatment.
- If the patient is an athlete or wishes to return to a high level of activity.
- Presence of associated injuries such as meniscal tears or collateral ligament injuries.
Post-Surgical Educational Guidelines:
- Rest, ice application, and leg elevation are essential during the first week.
- A gradual physical therapy program begins a few days after surgery.
- Gradual return to activity usually starts after 3 months.
- Full return to sports is typically allowed after 6–9 months.
- Strict adherence to the rehabilitation program is the key to a successful outcome.
Frequently Asked Questions About ACL & PCL Reconstruction
We fully understand the importance of having all the necessary information to make informed decisions about your health.
Therefore, we have compiled the most frequently asked questions about cruciate ligament reconstruction surgeries and provided clear and reliable answers.
We hope this section helps you gain a better understanding of the procedure.
The ACL prevents the tibia from sliding forward, while the PCL prevents it from sliding backward. Both ligaments are essential for knee stability.
Yes, provided that you fully adhere to the rehabilitation program and avoid rushing back to sports activities.
The procedure is performed under general or spinal anesthesia, and effective pain medications are used afterward, so postoperative pain is usually limited and well controlled.
This is rare and usually occurs due to poor adherence to rehabilitation or returning too early to intense physical activity.
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