When we experience more severe knee injuries such as from a car accident, ligaments other than ACL or meniscus can also be ruptured. Sports injury typically causes a torn ACL in the knee, but when the force of the injury is stronger,  as in rugby or soccer, the following knee ligaments also rupture:

PCL (posterior cruciate ligament)
LCL (lateral collateral ligament)
MCL (medial collateral ligament)
PLC (posterolateral complex)

 

These other ligament injuries are usually known as  PCL and multi-ligament injuries. These ligaments may be injured individually or the injury may involve two or more ligaments together. The term multi-ligament injury means two or more ligaments of the knee joint are injured together. ACL and meniscus injury may also be injuried along with these ligaments. The PCL, LCL, MCL or PLC injuries are often termed as complex ligament injuries or complex multi-ligament injuries.

The PCL is the most commonly injured complex ligament in any high velocity or high impact injury. The PCL is often injured together with the PLC, LCL and ACL.

 

Patients with PCL & multi-ligament injuries will initially suffer knee pain and swelling immediately after an accident. After a few days or weeks, the swelling will subside, but the knee will feel unstable. The patients will complain of 'giving way' of their knees. This knee instability or 'giving way' is more severe in cases where the PLC or LCL is ruptured together with the PCL. PCL and multi-ligament injuries can be confirmed with an MRI scan.

 

What is the treatment for PCL & multi-ligament injuries?

In cases where the PCL is only mildly injured, without additional complex ligaments injured as well, patients may not experience any knee instability. Such injury can be treated by just physiotherapy to strengthen the knee muscles and to improve the knee motion.

In more severe cases which  the PCL is ruptured and patients experience knee instability or when the PCL is injured together with another ligament, surgery is necessary to restore the knee stability and prevent long term development of knee osteoarthritis. PCL & multi-ligament injuries that  are not treated properly may lead to wear and tear of the cartilage in the knee or knee osteoarthritis in the long term. The surgery for treatment of PCL rupture involves reconstruction of the PCL under arthroscopy.

Other ligaments that are torn along with the PCL are also reconstructed simultaneously.

 

 

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