Posterior cruciate ligament tear

Dr Mohamed Saber and Dr Henry Knipe et al.

Posterior cruciate ligament (PCL) tears are less common than anterior cruciate ligament tears

Posterior cruciate ligament tears account for ~10% (range 2-23%) of all knee injuries 2

Sports injuries and car accidents (dashboard injury) are equally responsible for these injuries 1. Many patients will be asymptomatic and their clinical examination is unremarkable. However, some patients may have knee instability or posterior sag sign.

Three mechanisms of injury have been proposed 2:

  • posterior tibial displacement in a flexed knee
  • hyperextension
  • rotation with an abduction or adduction force

PCL injuries are isolated in only 30% of cases and are thus commonly associated with other injuries 1,2.4:

Features of posterior ligament tears include 1,2

  • PCL usually remains contiguous (~70%) although there may be complete or partial ligamentous disruption
    • absent PCL replaced by high T1 and T2 signal
  • enlarged and swollen PCL: >7 mm AP diameter of the vertical portion on sagittal imaging is indicative of a tear

PCL tears may result in chronic instability and early degenerative change 2

Knee pathology

The knee is a complex synovial joint that can be affected by a range of pathologies:

Article information

rID: 37582
Synonyms or Alternate Spellings:
  • PCL sprain
  • PCL injury
  • Posterior cruciate ligament sprain
  • Posterior cruciate ligament injury
  • Ruptured PCL
  • PCL tear
  • PCL rupture

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Cases and figures

  • Case 1
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  • Case 2
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  • Case 3
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  • Case 4
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  • Case 5
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  • Case 6
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  • Case 7
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  • Case 8: with hyperextension knee injury
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