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Posterior Cruciate Ligament Injury
Kirkland W. Davis, MD, FACR; Donna G. Blankenbaker, MD, FACR; Andrew Sonin, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Posterior cruciate ligament (PCL)
            • Synonyms

              • PCL tear
            • Definitions

              • Partial or complete disruption of PCL fibers or avulsion of their osseous attachments

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Gross Pathologic & Surgical Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          • Reporting Tips

                                            Selected References

                                            1. Verhulst FV et al: Diagnosing PCL injuries: history, physical examination, imaging studies, arthroscopic evaluation. Sports Med Arthrosc Rev. 28(1):2-7, 2020
                                            2. Badri A et al: Clinical and radiologic evaluation of the posterior cruciate ligament-injured knee. Curr Rev Musculoskelet Med. 11(3):515-20, 2018
                                            3. LaPrade CM et al: Emerging updates on the posterior cruciate ligament: a review of the current literature. Am J Sports Med. 43(12): 3077-92, 2015
                                            4. Levy BA et al: Advances in posterior cruciate ligament reconstruction. Instr Course Lect. 64:543-54, 2015
                                            5. Narvy SJ et al: Anatomy of the femoral footprint of the posterior cruciate ligament: a systematic review. Arthroscopy. 31(2):345-54, 2015
                                            6. Naraghi A et al: MR imaging of cruciate ligaments. Magn Reson Imaging Clin N Am. 22(4):557-80, 2014
                                            7. Park HJ et al: The usefulness of the oblique coronal plane in knee MRI on the evaluation of the posterior cruciate ligament. Acta Radiol. 55(8):961-8, 2014
                                            8. Wang JH et al: Effects of knee flexion angle and loading conditions on the end-to-end distance of the posterior cruciate ligament: a comparison of the roles of the anterolateral and posteromedial bundles. Am J Sports Med. 42(12):2972-8, 2014
                                            9. White EA et al: Cruciate ligament avulsion fractures: Anatomy, biomechanics, injury patterns, and approach to management. Emerg Radiol. Epub ahead of print, 2013
                                            10. Rosenthal MD et al: Evaluation and management of posterior cruciate ligament injuries. Phys Ther Sport. 13(4):196-208, 2012
                                            11. Chen B et al: Double-bundle posterior cruciate ligament reconstruction using a non-hardware suspension fixation technique and 8 strands of autogenous hamstring tendons. Arthroscopy. 25(7):777-82, 2009
                                            12. Hermans S et al: Long-term results of isolated anterolateral bundle reconstructions of the posterior cruciate ligament: a 6- to 12-year follow-up study. Am J Sports Med. 37(8):1499-507, 2009
                                            13. McAllister DR et al: Posterior cruciate ligament biomechanics and options for surgical treatment. Instr Course Lect. 58:377-88, 2009
                                            14. Sorrentino F et al: Role of high-resolution ultrasonography without and with real-time spatial compound imaging in evaluating the injured posterior cruciate ligament: preliminary study. Radiol Med. 114(2):312-20, 2009
                                            15. Jung YB et al: Characterization of spontaneous healing of chronic posterior cruciate ligament injury: Analysis of instability and magnetic resonance imaging. J Magn Reson Imaging. 27(6):1336-40, 2008
                                            16. Rodriguez W Jr et al: MRI appearance of posterior cruciate ligament tears. AJR Am J Roentgenol. 191(4):1031, 2008
                                            17. Bellelli A et al: Magnetic resonance imaging of posterior cruciate ligament injuries: a new classification of traumatic tears. Radiol Med. 111(6):828-35, 2006
                                            18. Cosgarea AJ et al: Posterior cruciate ligament injuries: evaluation and management. J Am Acad Orthop Surg. 9(5):297-307, 2001
                                            19. Sherman PM et al: MR imaging of the posterior cruciate ligament graft: initial experience in 15 patients with clinical correlation. Radiology. 221(1):191-8, 2001
                                            20. Shelbourne KD et al: Magnetic resonance imaging of posterior cruciate ligament injuries: assessment of healing. Am J Knee Surg. 12(4):209-13, 1999
                                            21. Sonin AH et al: MR imaging of the posterior cruciate ligament: normal, abnormal, and associated injury patterns. Radiographics. 15(3):551-61, 1995
                                            22. Fanelli GC et al: The posterior cruciate ligament arthroscopic evaluation and treatment. Arthroscopy. 10(6):673-88, 1994
                                            23. Patten RM et al: Complete vs partial-thickness tears of the posterior cruciate ligament: MR findings. J Comput Assist Tomogr. 18(5):793-9, 1994
                                            24. Sonin AH et al: Posterior cruciate ligament injury: MR imaging diagnosis and patterns of injury. Radiology. 190(2):455-8, 1994
                                            25. Miller MD et al: Posterior cruciate ligament injuries. Orthop Rev. 22(11):1201-10, 1993
                                            26. Barrett GR et al: Operative management of acute PCL injuries with associated pathology: long-term results. Orthopedics. 14(6):687-92, 1991
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Pathology

                                                  • Clinical Issues

                                                    • Diagnostic Checklist

                                                      TERMINOLOGY

                                                      • Abbreviations

                                                        • Posterior cruciate ligament (PCL)
                                                      • Synonyms

                                                        • PCL tear
                                                      • Definitions

                                                        • Partial or complete disruption of PCL fibers or avulsion of their osseous attachments

                                                      IMAGING

                                                      • General Features

                                                        • Radiographic Findings

                                                          • CT Findings

                                                            • MR Findings

                                                              • Imaging Recommendations

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Staging, Grading, & Classification

                                                                      • Gross Pathologic & Surgical Features

                                                                        CLINICAL ISSUES

                                                                        • Presentation

                                                                          • Demographics

                                                                            • Natural History & Prognosis

                                                                              • Treatment

                                                                                DIAGNOSTIC CHECKLIST

                                                                                • Consider

                                                                                  • Image Interpretation Pearls

                                                                                    • Reporting Tips

                                                                                      Selected References

                                                                                      1. Verhulst FV et al: Diagnosing PCL injuries: history, physical examination, imaging studies, arthroscopic evaluation. Sports Med Arthrosc Rev. 28(1):2-7, 2020
                                                                                      2. Badri A et al: Clinical and radiologic evaluation of the posterior cruciate ligament-injured knee. Curr Rev Musculoskelet Med. 11(3):515-20, 2018
                                                                                      3. LaPrade CM et al: Emerging updates on the posterior cruciate ligament: a review of the current literature. Am J Sports Med. 43(12): 3077-92, 2015
                                                                                      4. Levy BA et al: Advances in posterior cruciate ligament reconstruction. Instr Course Lect. 64:543-54, 2015
                                                                                      5. Narvy SJ et al: Anatomy of the femoral footprint of the posterior cruciate ligament: a systematic review. Arthroscopy. 31(2):345-54, 2015
                                                                                      6. Naraghi A et al: MR imaging of cruciate ligaments. Magn Reson Imaging Clin N Am. 22(4):557-80, 2014
                                                                                      7. Park HJ et al: The usefulness of the oblique coronal plane in knee MRI on the evaluation of the posterior cruciate ligament. Acta Radiol. 55(8):961-8, 2014
                                                                                      8. Wang JH et al: Effects of knee flexion angle and loading conditions on the end-to-end distance of the posterior cruciate ligament: a comparison of the roles of the anterolateral and posteromedial bundles. Am J Sports Med. 42(12):2972-8, 2014
                                                                                      9. White EA et al: Cruciate ligament avulsion fractures: Anatomy, biomechanics, injury patterns, and approach to management. Emerg Radiol. Epub ahead of print, 2013
                                                                                      10. Rosenthal MD et al: Evaluation and management of posterior cruciate ligament injuries. Phys Ther Sport. 13(4):196-208, 2012
                                                                                      11. Chen B et al: Double-bundle posterior cruciate ligament reconstruction using a non-hardware suspension fixation technique and 8 strands of autogenous hamstring tendons. Arthroscopy. 25(7):777-82, 2009
                                                                                      12. Hermans S et al: Long-term results of isolated anterolateral bundle reconstructions of the posterior cruciate ligament: a 6- to 12-year follow-up study. Am J Sports Med. 37(8):1499-507, 2009
                                                                                      13. McAllister DR et al: Posterior cruciate ligament biomechanics and options for surgical treatment. Instr Course Lect. 58:377-88, 2009
                                                                                      14. Sorrentino F et al: Role of high-resolution ultrasonography without and with real-time spatial compound imaging in evaluating the injured posterior cruciate ligament: preliminary study. Radiol Med. 114(2):312-20, 2009
                                                                                      15. Jung YB et al: Characterization of spontaneous healing of chronic posterior cruciate ligament injury: Analysis of instability and magnetic resonance imaging. J Magn Reson Imaging. 27(6):1336-40, 2008
                                                                                      16. Rodriguez W Jr et al: MRI appearance of posterior cruciate ligament tears. AJR Am J Roentgenol. 191(4):1031, 2008
                                                                                      17. Bellelli A et al: Magnetic resonance imaging of posterior cruciate ligament injuries: a new classification of traumatic tears. Radiol Med. 111(6):828-35, 2006
                                                                                      18. Cosgarea AJ et al: Posterior cruciate ligament injuries: evaluation and management. J Am Acad Orthop Surg. 9(5):297-307, 2001
                                                                                      19. Sherman PM et al: MR imaging of the posterior cruciate ligament graft: initial experience in 15 patients with clinical correlation. Radiology. 221(1):191-8, 2001
                                                                                      20. Shelbourne KD et al: Magnetic resonance imaging of posterior cruciate ligament injuries: assessment of healing. Am J Knee Surg. 12(4):209-13, 1999
                                                                                      21. Sonin AH et al: MR imaging of the posterior cruciate ligament: normal, abnormal, and associated injury patterns. Radiographics. 15(3):551-61, 1995
                                                                                      22. Fanelli GC et al: The posterior cruciate ligament arthroscopic evaluation and treatment. Arthroscopy. 10(6):673-88, 1994
                                                                                      23. Patten RM et al: Complete vs partial-thickness tears of the posterior cruciate ligament: MR findings. J Comput Assist Tomogr. 18(5):793-9, 1994
                                                                                      24. Sonin AH et al: Posterior cruciate ligament injury: MR imaging diagnosis and patterns of injury. Radiology. 190(2):455-8, 1994
                                                                                      25. Miller MD et al: Posterior cruciate ligament injuries. Orthop Rev. 22(11):1201-10, 1993
                                                                                      26. Barrett GR et al: Operative management of acute PCL injuries with associated pathology: long-term results. Orthopedics. 14(6):687-92, 1991