The knee joint is the largest and most complex joint in the body, carrying approximately 90% of the body’s gravity. Its balance and steady state are mainly reinforced by the surrounding ligaments and tendons. The posterior cruciate ligament (PCL) is an important factor in stabilizing the knee joint and is the strongest ligament within the knee joint, guiding and limiting knee motion. PCL injuries are often seen in two situations, one is a high-energy injury, common in traffic accidents, high falls, etc. This situation is often combined with injuries to the anterior, medial, and lateral structures of the knee, so it is often a compound ligament injury; and the other is a sports injury, this is a low-energy injury, the athletes are mostly isolated PCL injury, the former often left knee instability, seriously affecting the patient walking function The former often leaves instability in the knee, severely affecting the patient’s walking function, and often requires surgical treatment. Patients with the latter low-energy PCL injuries often have less than 2 degrees of posterior laxity of the knee and can often be treated conservatively with satisfactory results, but if the injury is severe, with more than 3 degrees of posterior laxity, surgery should also be actively treated. If the patient also has a combined intra-articular meniscal injury, early arthroscopic repair of the meniscus and reconstruction of the posterior cruciate ligament in one or two stages, as appropriate, is indicated. In recent years, with the expansion of the sports population and the motorization of transportation, posterior cruciate ligament injuries have become more and more common, and more and more patients with posterior cruciate ligament injuries and multiple knee ligament injuries have been treated by our orthopedic department in University City, and we would like to answer some of your questions in the hope of helping these patients. 1.How can I determine if my posterior cruciate ligament is injured? Patients with acute posterior cruciate ligament injuries usually suffer from greater violence, such as car accident injuries, serious knee impact injuries in sports, etc., which can easily lead to posterior cruciate ligament injuries. After the injury, the knee joint has obvious pain and swelling when moving, and walking is difficult. Patients with chronic posterior cruciate ligament injuries may experience knee tenderness, pain, difficulty moving or walking up and down stairs, and a lack of strength if the acute phase is not treated systematically. Patients with multiple ligament injuries, such as lateral collateral ligament injuries, may experience severe limping, crippling, and difficulty walking. Of course, the best way is to go to a sports trauma clinic, and a medical examination by a specialist will enable early diagnosis and treatment. 2.What tests should I have? For patients with posterior cruciate ligament injury, doctors can often find positive anterior and posterior knee drawer test during physical examination, and patients can often feel the looseness of the doctor’s physical examination, the posterior drawer test is the most sensitive test for posterior cruciate ligament injury. For patients in the acute stage, due to the severe injury, the patient is in pain and has difficulty in cooperating with the physical examination, so an early MRI or physical examination under anesthesia can be performed to help make a clear diagnosis early and provide early treatment. 3.Do I need surgery for my knee ligament injury? As mentioned above, acute injury of simple posterior cruciate ligament with low energy (less than 2 degrees) can be treated strictly conservatively with knee brace for 3 months, and good results can be expected, while patients with other ligament or meniscus or cartilage injuries in the knee joint and those with severe posterior cruciate ligament injury of more than 3 degrees should consider early arthroscopic minimally invasive surgery. For patients with chronic laxity of the knee, arthroscopic surgery should be considered to reconstruct the laxity of the posterior cruciate ligament. 4. What is the surgical approach? Which surgical option is right for me? The main surgical option for a simple posterior cruciate ligament injury is to reconstruct the posterior cruciate ligament. For first-time patients, an arthroscopic bone tunneling procedure is the best option, while for revision patients who have failed the initial surgery, an inlay technique is preferred. In patients with compound ligament injuries that are combined with other ligament injuries, the posterior cruciate ligament should be repaired and reconstructed along with other related ligaments as appropriate. For particularly severe patients even bone orthopedic surgery is required to correct the force lines of the lower extremity. 5.Is it better to have autologous or allogeneic grafts or artificial ligaments? For posterior cruciate ligament reconstruction surgery, the graft can be autologous, allograft or artificial ligament. Autologous ligament reconstruction is more economical, but it needs to destroy some normal secondary ligaments of oneself, while allograft ligaments do not need to damage one’s own ligaments, but they are more expensive and may have rejection reactions in rare cases. Artificial ligaments are stronger and have a faster recovery time, but are more expensive. In conclusion, each of the 3 types of grafts has its own advantages and disadvantages, and patients and doctors can choose grafts according to their specific conditions. 6.What is the length of hospitalization and recovery time for surgery? The posterior cruciate ligament reconstruction surgery usually requires about 1 week of hospitalization and systematic functional rehabilitation exercises under the guidance of the doctor after the surgery. Patients with a simple posterior cruciate ligament injury need to be in abduction within 1-2 months, and it takes about 3 months to resume daily life, and often 10-12 months to resume sports. Patients with multiple knee ligament injuries have a longer rehabilitation time, usually taking about 12 months. 7. What is the cost of posterior cruciate ligament reconstruction surgery? Usually the cost of an autologous posterior cruciate ligament reconstruction surgery is about 30,000 yuan, and the out-of-pocket expense for patients with Guangzhou medical insurance is about 50%, or about 15,000 yuan. For patients with multiple ligament injuries, the cost varies depending on the specific injury. 8.Do I need to be hospitalized for rehabilitation? Post-operative rehabilitation is very important for patients with posterior cruciate ligament or multiple ligament injuries, and good surgery + good functional exercise is the only way to have good results. Postoperative patients are guided by doctors to perform functional rehabilitation exercises during the hospital, and exercise at home after discharge. Patients with posterior cruciate ligament and multiple ligament injuries sometimes have postoperative knee stiffness, etc. If it is more difficult to recover on your own, sometimes you need to be hospitalized again for rehabilitation, or with post-anesthesia massage and release methods to speed up the functional rehabilitation of the knee. 9.What is the overall outcome of posterior cruciate ligament injury? According to the international and domestic literature, the functional score after treatment of simple mild posterior cruciate ligament injury is about 80-85% of the normal knee (88.5% in our department), and the knee function of patients with multiple ligament injuries and other compound injuries is 70-85% of normal (82.5% in our department). The functional recovery of patients with injuries such as posterior cruciate ligament stop fractures in our department can reach 95% of the healthy side. Conclusion: The posterior cruciate ligament is the thickest and strongest ligament structure in the knee joint and has a large impact on the knee function after injury. Good postoperative rehabilitation is an important part of the overall treatment. The treatment of posterior cruciate ligament injuries is often a systemic project. University City Sports Trauma Team will serve every patient with international first-class sports trauma diagnosis and treatment technology, try to save every patient with knee ligament injury, and do our best to let every patient enjoy sports!