Posterior cruciate ligament reconstruction

While an ACL tear is known for its popping sensation, a PCL tear causes pain and swelling that can worsen over time. The knee might feel unstable, or you might experience pain in the back of the knee when the leg is bent.

You will need to book a consultation with a knee specialist, who can examine your knee thoroughly. You may also be referred for diagnostic scans, such as an X-Ray, so that the damage can be seen more clearly.

Whether or not you need surgery will depend on the extent of the damage. PCL tears are often graded 1-4, with 1 being a partial tear and 4 being a tear to the PCL and another ligament. If the damage is extensive (e.g. a complete tear), surgery may be the next course of action.

Some patients with an injured PCL find that non-surgical interventions relieve their symptoms. You could try the RICE technique – rest, ice, compression and elevating the leg. You might also find it helps to wear a brace and use crutches.

Physiotherapy – particularly exercises to strengthen your thigh muscles – will also be an essential part of your recovery.

PCL reconstruction surgery usually takes around 1 hour and can be performed arthroscopically (using a minimally invasive keyhole technique). Most patients are placed under a general anaesthetic, but you could also have a local or spinal anaesthetic. Your surgeon will discuss these options with you.

The aim of a PCL reconstruction is to use a graft from a healthy tendon, such as the hamstring, to repair the ligament. A graft can also come from a deceased donor, which is a procedure known as an allograft.

Your surgeon will make a small incision and insert a camera into the knee joint. Once they can see the damaged area on the screen, they can either reattach the torn ligament or attach a new graft to the bone.

It’s our aim to make sure you’re fully prepared ahead of any procedure. After all, we want you to be as relaxed as possible on the day of your surgery.

Most patients will be asked not to drink or eat anything before surgery. You might also be asked to stop smoking or to stop taking certain medications. Your consultant will discuss these requirements with you ahead of the procedure.

Most patients can go home on the same day as their surgery. You will need to consider how you are planning to get home after surgery, as you won’t be able to drive after a general anaesthetic and will be on crutches.

Once you’re at home, physiotherapy will be an important part of your recovery. We have a team of physiotherapists here to guide you through exercises you can do at home, and you will return to the Knee Surgery Unit after a few weeks so that we can review your progress.

PCL reconstruction surgery typically has good outcomes, but all surgery carries risks. Complications can include pain, bleeding, infection (at the surgical site) and blood clots (including the risk of deep vein thrombosis). You might also experience swelling or limited range of motion.

There is also the risk that the graft won’t work, and further interventions will be required. Your surgeon will discuss the risks and limitations of PCL reconstruction surgery with you ahead of the procedure.

You may be covered by private medical insurance, or you may wish to consider spreading the cost of your surgery by opting for a monthly payment plan.

We aim to make our costs as transparent as possible, but it’s important to talk everything through in detail with your consultant at the time of your appointment. Some costs may be paid directly to the hospital, while others, such as your consultant fees, may be paid directly to the consultant.