I completely tore my PCL (grade 3 tear) sliding into the boards during a beer league game in October and have seen several sports medicine doctor and orthopaedic surgeons to discuss options. The gist of what I’ve learned is this:
-PCL injuries are very rare because the ligament is twice as strong as the ACL, so it takes tremendous force to tear the PCL.
-Fully torn PCLs never heal completely on their own. If you don’t have surgery, you just live without your PCL.
-Whether you need surgery depends on whether other ligaments were damaged as well and how unstable your knee is. In my situation, the other ligaments and cartilage were OK, and my instability wasn’t too bad, so the doctors recommended I do rehab instead of surgery.
-Rehab involves a lot of quad and hip exercises. These muscles pull the shin bone (tibia) forward after a torn PCL causes the shin bone to slide backwards.
-the biggest risk with a torn PCL is it eventually might lead to arthritis (and eventual knee replacement surgery) because of stresses on the knee joints from different load-bearing. Higher risk of arthritis if you also had cartilage damage.
-PCL surgeries are risky and complicated as it involves going in through the back of the knee and most surgeons rarely do them. Even with surgery, it’s not entirely clear whether you’ll recover properly or avoid arthritis. After PCL surgery, it takes 9-12 months to return to sports.
-the pain never really goes away, or at least it takes a long, long time (years). I still feel very sharp pains in the back of my knee during some lateral movements, and my entire knee goes numb for a while if I tweak it.
Rehab’s been pretty gruelling but for me the 2 most nerve-wracking things are: 1) will I ever be able to play hockey and basketball again without pain and 2) will I eventually get arthritis and need a knee replacement
This is just a laymans view but an experienced one nonetheless. I had extensive knee damage in my left knee in a hockey game age 18. ACL damage, cartilage, meniscus damage. Then totaled my other knee in a work related accident 5yrs later, again similar injuries but this time with PCL damage. I was 23 and both knees were f***ed. Given that I had extensive injuries in both knees (rehabbed both as much as I could and its a lifelong process) it was estimated by Orthopaedic surgeons that I would require knee replacements , both knees, by age 40.
I'm 58. I have had zero knee replacements. X Rays/ct scan reveal a lot of damage in there and of course advancing arthritis. But I still can hike, cycle, workout, train, and can for as long as I want and go far as I want. I've mitigated limitations and arthritis by staying active in non contact sports. In exercise that is as non contact as possible. By all means say goodbye to Basketball, say goodbye to playing hockey. You got one body, that's it, and I wish somebody had told me something like this when I was a kid before I totalled both knees at a young age.
I do knee exercises and rehab almost every day. Couldn't walk without it. But with keeping on top of this I can do anything I want and limit pain, arthritis. While in the past I had occasional bouts of grinding and contact in the joints I've made adjustments to my rehab and haven't had this in years. I can walk or hike about 5miles before discomfort. Leg lifts and leg pulls are very helpful to me, I work out the joints in the gym but also at home using stretch bands. The stretch band workouts particularly seem like a magic elixir cure for arthritis pain.
I'm going out snowshoeing 5 miles this afternoon. I get regular and varied activity. Snowshoeing is fantastic for knee, back or hip injuries. More people should do it.
I think the doctors made the right call in your case. The surgery, especially PCL, can create some damage. I've never had surgery, wish to avoid it, and I lived a good active life without it. Just important to adjust what activities you do. Try not to fight the inclination. I made the mistake of trying to continue to jog. I just refused to adjust in my 20's. But then grew up and accepted I had to make changes in activity. it makes all the difference.
