Posterior cruciate ligament injuries of the knee joint

Posterior cruciate ligament (PCL) injuries have a reported incidence of bet ween 3 and 37%, depending on the clinical setting. The most common mechanis m of injury in motor vehicle accidents is a dashboard injury or direct forc e to the proximal anterior tibia. Sports related injuries result from hyper flexion of the knee with the foot typically plantarflexed. The latter mecha nism is the most common cause of isolated PCL injuries, while in the trauma population as many as 95% of patients with knee injuries have combined lig amentous damage. Improved knowledge at an anatomical, biomechanical and cli nical level has provided the orthopaedist with a more defined treatment alg orithm. Isolated, partial PCL injuries (grades I and II) can best be treate d nonoperatively while complete injuries (grade III) may require operative treatment based on clinical symptoms. All combined ligamentous injuries usu ally respond best with surgical management.