Posterior cruciate ligament (PCL) reconstruction

A surgical procedure to correct posterior cruciate ligament (PCL) damage.

About posterior cruciate ligament (PCL) reconstruction

PCL surgery repairs damage caused by trauma to the knee. During surgery, a piece of tendon from another part of your body replaces the injured PCL (a graft). This tendon then acts as scaffolding for new ligament tissue to grow along.

The PCL is a thick band of tissue that joins the back of the shin bone to the inside of the thigh bone. It stops the knee bending backwards and stabilises it during rotational movements.

Your PCL may get torn following impact on the front of your knee when it is in a flexed position. This might be due to a fall onto a bent knee, impact during a car crash or during a tackle in sport.

Sometimes PCL damage can be resolved with physiotherapy, but if your symptoms don't improve or if there is a complete tear, your consultant is likely to recommend surgery.

How is PCL reconstruction carried out?

PCL reconstruction is usually carried out through keyhole surgery (arthroscopically). It is usually done under general anaesthetic, which means you'll be asleep during the procedure.

Your orthopaedic surgeon makes three small cuts in your knee and inserts a telescopic video camera and surgical instruments.

First, your surgeon will cut a section of tendon from your thigh (the hamstring) or knee. They will then drill small holes in your thigh bone and shin bone, and insert the ends of the tendon.

This tendon (graft) will be fixed in place with screws or staples. Donor tendons can also be used (allografts). You should discuss this option with your surgeon.

The area is then closed using surgical tape or dissolvable stitches, and a dressing is applied.

Recovering from PCL reconstruction surgery

You should be able to go home on the same day as the surgery, or as soon as you have recovered from the anaesthetic.

It usually takes about six weeks to heal, although it can be as long as 12 weeks.

During the first six weeks, you'll need to wear a leg brace to limit the movement of your knee, and you'll need to use crutches to keep the weight off it.

Your physiotherapist will give you some gentle exercises to help build up the muscles and mobility of your knee.

You should be able to return to work four to six weeks after the operation, if your job isn't physically demanding. Those with more active jobs will need a longer recovery time.

It usually takes six months to make a full recovery and return to sports.

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Published: 10 December 2019 | Review: 10 December 2022

Disclaimer: This information is published by Cromwell Hospital and is based on reputable sources of medical evidence and experience from over 30 years of treating patients. It has been peer reviewed by Cromwell Hospital doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional. If you have any feedback on the content of this patient information document please email or telephone 020 7460 5901.