A 32-year-old soccer player sustains an isolated posterior cruciate ligament (PCL) injury. Posterior drawer test is 2+ positive at 90° flexion. MRI confirms complete PCL tear. All other ligaments are intact. The initial management for an isolated acute PCL injury in this setting should be:
- A Immediate PCL reconstruction with hamstring autograft
- B Functional rehabilitation focusing on quadriceps strengthening ✓
- C Immobilization in full extension for 6 weeks
- D Posterior tibial support brace for 3 months followed by reassessment
Explanation
Isolated PCL tears (even complete) are generally managed non-operatively with a structured rehabilitation program. The quadriceps muscle acts as a dynamic PCL substitute by creating an anterior vector force at the proximal tibia during knee extension, counteracting posterior tibial subluxation. Most patients with isolated PCL injuries achieve good functional outcomes with aggressive quadriceps strengthening (open-chain quad sets and leg press). Surgical reconstruction is reserved for combined ligamentous injuries (PCL + PLC or MCL) or for isolated Grade III tears that fail conservative management after 3–6 months.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.