Understanding PCL Reconstruction
The posterior cruciate ligament (PCL) sits behind the ACL and stops the shin bone sliding backwards. It is injured far less often than the ACL, usually by a direct blow to the front of a bent knee, and many injuries recover with rehabilitation alone.
When the PCL injury is high-grade, combined with other ligament damage, or leaves the knee unstable, reconstruction rebuilds it with a graft using arthroscopic techniques, followed by carefully graded rehabilitation in a dedicated brace.
Key benefits
- Restores backward stability of the knee
- Protects the cartilage from uneven loading over time
- Arthroscopic approach with a structured recovery
When PCL Reconstruction is recommended
How the procedure is performed
Assessment
The extent of the PCL injury and any associated ligament or meniscus damage is confirmed arthroscopically.
Graft preparation
A suitable graft is harvested and prepared for reconstruction.
Reconstruction
Bone tunnels are placed accurately and the graft is fixed to restore the ligament's natural function.
Bracing
A dedicated PCL brace supports the shin bone to protect the graft during early healing.
Preparation & prerequisites
- A detailed clinical assessment and review of your scans (X-ray / MRI) to confirm the diagnosis and plan the surgery precisely.
- Routine pre-operative blood tests, an ECG if needed, and a fitness-for-anaesthesia check by the anaesthetist.
- Stopping blood-thinning medication (such as aspirin or clopidogrel) only if advised, and disclosing every medicine and supplement you take.
- Fasting for around 6 hours before surgery, and arranging a responsible adult to drive you home and stay with you the first night.
- Preparing your home for recovery — ice packs, loose clothing, and a clear path free of trip hazards.
What recovery looks like
Weeks 0–6
A PCL brace protects the graft while gentle, guided movement begins and swelling settles.
Weeks 6–16
Weight-bearing and quadriceps-focused strengthening progress under close supervision.
Months 4–9
Sport-specific rehabilitation leads to a staged, tested return to activity.
How to recover well
- Follow the RICE principle early — rest, ice 15–20 minutes several times a day, gentle compression and elevation to control swelling.
- Take pain relief as prescribed rather than waiting for pain to build, and keep the wound clean and dry.
- Attend every physiotherapy session and do your home exercises — rehabilitation is as important as the surgery itself.
- Progress activity gradually and don't return to sport until you're formally cleared, to protect the repair.
- Watch for warning signs — spreading redness, fever, calf pain or increasing swelling — and call us if they appear.
Risks, safety & outcomes
In experienced hands this is a very safe procedure, and serious problems are uncommon. Every step is taken to minimise risk — but being fully informed is part of good care. Possible risks include:
- Residual laxity that occasionally needs further rehabilitation
- Stiffness from the protective early phase
- Infection or blood clot (uncommon)
Results & outlook
Reconstruction combined with dedicated rehabilitation restores stability and function for most patients, protecting the knee from the uneven wear that long-term instability can cause.
Frequently asked questions
No — many isolated PCL injuries recover well with a brace and rehabilitation. Surgery is reserved for high-grade, combined or persistently unstable injuries.