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Nonoperative Treatment of PCL Injuries: Goals of Rehabilitation and the Natural History of Conservative Care

  • PCL Update (K Jones and M Alaia, section editors)
  • Published:
Current Reviews in Musculoskeletal Medicine Aims and scope Submit manuscript

Abstract

Purpose of Review

To review the current practices of nonoperative management of posterior cruciate ligament (PCL) injuries, the natural history of conservative care, and the latest PCL rehabilitation strategies.

Recent Findings

PCL injuries often occur as part of a multiligamentous knee injury and occasionally occur in isolation. Although patients may be able to tolerate or compensate for a PCL-deficient knee, long-term outcomes after conservative care demonstrate a high rate of arthrosis in the medial and patellofemoral compartments resulting from altered knee kinematics and loads. Good subjective outcomes and a high rate of return to sport have been reported after nonoperative treatment of isolated PCL injuries. However, PCL laxity grade on objective exam does not typically correlate with subjective outcomes, nor does it correlate with the risk of developing osteoarthritis. Although more research is needed on the optimal PCL rehabilitation strategies, general principles include avoiding posterior tibial translation in the initial period to optimize ligament healing, followed by progressive range of motion and strengthening of the quadriceps and core musculature. At 12 weeks, patients may begin an interval running program, followed by agility work and progressive sports-specific training to allow for return to sports.

Summary

Nonoperative treatment of isolated PCL injuries results in good subjective outcomes and high rate of return to sport.

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Author information

Authors and Affiliations

  1. Sports Medicine and Shoulder Service, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA

    Dean Wang & Riley J. Williams III

  2. ADI Rehab, Los Angeles, CA, USA

    Jessica Graziano

  3. Department of Orthopaedic Surgery, University of California, Los Angeles, Los Angeles, CA, USA

    Kristofer J. Jones

Authors
  1. Dean Wang
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  2. Jessica Graziano
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  3. Riley J. Williams III
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  4. Kristofer J. Jones
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Correspondence to Dean Wang.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on PCL Update

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Wang, D., Graziano, J., Williams, R.J. et al. Nonoperative Treatment of PCL Injuries: Goals of Rehabilitation and the Natural History of Conservative Care. Curr Rev Musculoskelet Med 11, 290–297 (2018). https://doi.org/10.1007/s12178-018-9487-y

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  • DOI: https://doi.org/10.1007/s12178-018-9487-y

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