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In this position, the PCL functions to prevent movement of the tibia in the posterior direction [7] [13] and to prevent the tilting or shifting of the patella. [14] However, the respective laxity of the two sections makes the PCL susceptible to injury during hyperflexion, hyperextension, [15] and in a mechanism known as a dashboard injury. [9]
The PCL is located within the knee joint where it stabilizes the articulating bones, particularly the femur and the tibia, during movement.It originates from the lateral edge of the medial femoral condyle and the roof of the intercondyle notch [2] then stretches, at a posterior and lateral angle, toward the posterior of the tibia just below its articular surface.
Injuries to the PLC often occur in combination with other ligamentous injuries to the knee; most commonly the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL). [2] As with any injury , an understanding of the anatomy and functional interactions of the posterolateral corner is important to diagnosing and treating the injury.
grade 2: minor tears of less than one-half the thickness of the cartilage layer; grade 3: lesions have deep crevices of more than one-half the thickness of the cartilage layer; grade 4: the cartilage tear is full thickness and exposes the underlying (subchondral) bone; Doctors will often also measure the size of each defect.
Timing is important to wound healing. Critically, the timing of wound re-epithelialization can decide the outcome of the healing. [11] If the epithelization of tissue over a denuded area is slow, a scar will form over many weeks, or months; [12] [13] If the epithelization of a wounded area is fast, the healing will result in regeneration.
The prognosis of ACL injury is generally good, with many people regaining function of the injured leg within months. [2] ACL injury used to be a career-ending injury for competitive athletes; however, in recent years ACL reconstruction surgery followed by physical therapy has allowed many athletes to return to their pre-injury level of performance.
Most ACL tears are a result of a non-contact mechanism such as a sudden change in a direction causing the knee to rotate inward. As the knee rotates inward, additional strain is placed on the ACL, since the femur and tibia, which are the two bones that articulate together forming the knee joint, move in opposite directions, causing the ACL to tear.
This involves repairing the ACL by re-attaching it, instead of performing a reconstruction. Theoretical advantages of repair include faster recovery [2] and a lack of donor site morbidity, but randomised controlled trials and long-term data regarding re-rupture rates using contemporary surgical techniques are lacking.