PCL

Question 1

Anterolateral PCL most taut in?

Answer 1

FlexionPo

Question 2

Posteromedial PCL most taut in?

Answer 2

extension

Question 3

Mechanism of PCL injury

Answer 3

• Hyperflexion
• Direct Blow to anterior tibia (Dashboard injury)
• Excessive rotation

Question 4

Signs & Symptoms of PCL injuries

Answer 4

• Posterior Pain when kneeling
• May radiate into calf
• Limited ROM, but not always
• Mild Edema
• popping
• Infrequent Instability (Doesn’t have feelings of giving away)

Question 5

How does Varus stress influence PCL injury

Answer 5

• Varus stress can damage LCL, leading to compensation from PCL & posterolateral corner

Question 6

How is PCL characteristics different than ACLs’?

Answer 6

• PCL symptoms usually more vague, athletes can still function with an injury
• • PCL injury causes progressive disability, not instability (lack of posterior ligaments can be affected)

Question 7

Why can an individual with PCL injury present with a positive Lachman test?

Answer 7

• because tibia is already at a more posterior location, can give false information

Question 8

Special tests for PCL Examination

Answer 8

• Posterior sag sign
• Hughston Test
• Posterior drawer
• Godfrey’s test
• Reverse Lachman’s

Question 9

PCL injury classification

Answer 9

• look at the relative location of medial tibial plateau with medial femoral condyle
• Grade I: 0-5mm posterior translation
• Grade II: 5-10 mm posterior translation
• Grade III: greater than 10mm posterior translation

Question 10

what grades of PCL injury would you do Conservative Rehab

Answer 10

• Grade I & II
• Grade III in non-athletic population

Question 11

When do you do surgery for PCL injury?

Answer 11

• failed conservative cases
• acute Grade III in athletes
• Evidence of functional instability, joint degeneration & pain

Question 12

Why can PCL early rehab develop Quad-dominant knee

Answer 12

• because the process would involve strengthing quads to move the tibia forward
• Vice versa, ACL early rehab would develop Hamstring dominant knee

Question 13

Would you prevent varus or valgus stress with posterior translation of tibia

Answer 13

• varus

Question 14

What ROM would you performce for Grade I/II conservative rehav

Answer 14

-PROM
- Careful AROM
- Resisted ROM limited to 0-60 flexion

Question 15

What are the 3 key factors to consider for Muscle Re-training

Answer 15

• Quadriceps strengthing most important
• Avoid early hamstring activity
• CKC Exercises between 0-45 degree flexion & Terminal extension only

Question 16

Why can’t the patient perform downhill walking during rehab?

Answer 16

• because the ROM would push the tibia into posterior translation

Question 17

Strengthening emphasis on PCL injury

Answer 17

• Quad strengthening
• Close chain exercise knee extension: 0-60 degrees
• Isokinetics at week 8
• Initiate hamstrings at week 8