How ACL and PCL Injuries Differ?

There are two major ligaments in the knee that provide stability to the knee, known as anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL). These ligaments are prone to tears, more particularly in athletes. ACL and PCL injuries are likely to have similar symptoms initially, such as knee pain and instability. However, there are certain differing elements about the injury regarding who is affected, injury type and treatment plan.

ACL and PCL are the knee joint’s crisscrossing ligaments that allow the knee to flex without any harm. The ACL is in charge of preventing the tibia and femur from sliding forwards, and PCL keeps them from sliding backwards.

SYMPTOMS

ACL and PCL injuries can present with similar symptoms, including pain, swelling and instability of the knee. However, the difference is noticeable with the severity of the injury.

ACL is comparatively smaller and weaker than PCL. Hence it is prone to complete tears. There is an audible ‘pop’ sound the moment the anterior cruciate ligament ruptures. The damage caused to the ACL is extendable to the nearby ligaments and the meniscus. Therefore, the pain caused by an ACL tear is more than that of a PCL tear. ACL tear might as well cause loss of range of motion. The swelling due to an ACL tear will develop gradually over 24 hours.

PCL begins stronger than ACL usually sustains partial tears. However, the swelling is seen immediately, and the pain is less severe.

CAUSES

Sports mishaps can lead to either an ACL or PCL tear. If the injury happens due to a sudden stop, awkward landing from a jump or change of direction, it is likely an ACL tear.

Athletes in poor physical condition, ill-fitting footwear and those playing on slippery artificial turf are likely to suffer from a sport-related ACL injury.

Interestingly, women are more prone to ACL tears than men. The injuries due to bending of the knee are usually PCL tears. PCL can sustain the damage if the knee jams into the dashboard in an accident or you fall with your knee in a downward direction.

DIAGNOSIS

A physical exam is necessary for the doctor to diagnose an ACL or PCL injury and look for the visible signs and symptoms. For example, if it is an ACL tear, the knee will be tender to touch near the joint line and flexing the knee will be challenging. There might as well be spasms of hamstring muscles at the back of the thigh.

PCL tear is comparatively easier to diagnose because of the backward, sagging appearance of the knee as if it is bent. An X-Ray or MRI can be done to confirm the suspected diagnosis.

TREATMENT

Like the symptoms, the treatment for ACL and PCL tears can be similar. The following are the grades of injury that determine the treatment-

  • Grade 1- The knee is stable with the ligament slightly stretched.
  • Grade 2- the ligament is partially torn or loose.
  • Grade 3- The ligament is completely ruptured.

According to the diagnosed grade of the injury, you might be suggested the RICE treatment that stands for rest, ice, compression and elevation. Post-injury, you need to strengthen your joint and range of motion, for which physical therapy is required. If the tear is severe, you may require arthroscopic surgery or ligament reconstruction.

People who aren’t active much or are aged use knee braces or assisted mobility devices to deal with ACL injuries. On the contrary, PCL injuries can heal on their own without any surgical needs. You might need crutches and a knee immobiliser to avoid knee movement, but that’s all.

For more information on ACL and PCL, or to undergo treatment for injuries, call and schedule an appointment with Dr. Rewat Laxman & Dr. Gautam Kodikal.