Diagnosing posterior cruciate ligament injuries

Posterior cruciate ligament (PCL) injuries are difficult to detect because patients rarely present with findings that suggest a severe ligament injury. The keys to diagnosis include learning the mechanism of injury and performing a posterior drawer test. A complete knee exam rules out associated injuries. Nonoperative treatment is indicated for low-grade, isolated PCL injuries, but patients should be monitored for any degenerative changes. Combined injuries, high-grade injuries, and avulsion fractures require surgery. Rehabilitation goals for all PCL injuries include regaining full range of motion and quadriceps strength.