Epidemiology, Signs & Symptoms
What group is most likely to tear their PCL?
A. Toddlers in daycare
B. 15-20 year old athletes
C. 30-40 year olds
D. 50-60 year olds
B. 15-20 year old athletes
- Athletes younger than 15 are more likely to suffer avulsion fractures where the ligament actually pulls part of the bone off at the attachment point. This is because at that age the ligament is stronger than the bone.
What is the Gold standard of imaging for a potential PCL tear?
A. X-ray
B. MRI
C. CT Scan
D. Ultrasound
B. MRI
- MRI is generally going to be the most effective imaging for soft tissue injuries.
Which of these is NOT an initial goal of PCL injury Rehab?
A. Restoring ROM of the knee
B. Reducing pain and swelling
C. Returning to full activity
D. Promoting weight bearing in safe positions
C. Returning to full activity
- While this would be a long term goal of PCL rehab, it is generally a result of achieving the initial goals and progressing to more complex and dynamic movements.
Which of the following practitioners would be least ideal for co-managing a PCL tear with a Chiropractor?
A. Physical Therapist
B. Orthopedic Surgeon
C. Primary Car Physician
D. Karyn
While Karyn may someday become suitable for helping discover a PCL tear, as a student, she currently would be the least ideal person of the bunch to help co-manage this injury with a Chiropractor. HA HA
- Depending on the severity and where the patient is at in their recovery/treatment a chiropractor could work with any of these practitioners in order to get a positive patient outcome.
In which of these sports do PCL tears more commonly occur?
A. Baseball
B. Soccer
C. Bowling
D. Croquet
B. Soccer
- Sports where an athlete has a higher potential for hyperextension of the knee such as soccer, football, and basketball will have more common occurrences of PCL injuries.
Upon initially tearing the PCL, which movements are unstable?
A. Side Cutting
B. Walking down stairs
C. Jumping
D. All movements are unstable
D. All Movements
- All of these are movements that utilise the PCL and would be unstable if the PCL is compromised.
3. In what grade of PCL tear is an MRI necessary?
A. Grade 1: The ligament is slightly stretched but you should look just in case.
B. Grade 2: The knee is a little unstable, but tell them to suck it up.
C. Grade 3: Imaging? Of course, they completely tore their PCL!
D. An MRI is dependent upon Pt symptoms, doctor findings, and/or response to conservative care.
D. An MRI is dependent upon Pt symptoms, doctor findings, and/or response to conservative care.
- Most often an MRI would be requested based on the presentation and symptoms of the patient. A patient with a grade 1 sprain could receive an MRI if they do not respond well to conservative care. If the doctor notices significant instability or believes there could be a significant tear of the ligament they would request an MRI.
Which muscle group should be strengthened to help support a weak PCL?
A. Quadriceps
B. Calf
C. Hip Flexors
D. Glutes
A. Quadriceps
- The quadriceps help keep the tibia from translating posterior.
What is the recovery time for a PCL reconstruction surgery?
A. Less than 3 months
B. 3-6 months
C. 6-9 months
D. 12-18 months
C. 6-9 months
- With apropriate rehab and patient compliance, they should be back to 100% by 9 months post op.
How many different grades of PCL sprains/tears are there total?
A. 2
B. 3
C. 4
D. 5
B. 3
- While there are some texts that refer to 4 grades of ligament sprains/tears, the 4th grade is used to document tearing of surrounding structures and not the ligament itself.
A person is unable to perform normal daily activities with a complete tear/rupture of the PCL.
A. True
B. False
B. False
- Unless they are an athlete, strengthening of tissue around the ligament and joint will allow the person to live with a full tear of the PCL.
What grade of PCL tear is the Ligament mildly damaged and slightly stretched, yet the knee joint is stable?
A. Grade 1
B. Grade 2
C. Grade 3
D. Grade 4
A. Grade 1
- Grade 1 is defined as still having a stable joint with slight stretching while a grade 2 would present with joint instability and show partial tearing with an MRI.
Which of these vitamins is best for ligament repair?
A. Vitamin A
B. Vitamin B
C. Vitamin C
D. Vitamin D
Vitamin C
- When paired with collagen, it works to help repair ligament fibers in the human body.
What is the success rate of PCL surgery?
A. 65%
B. 75%
C. 85%
D. 95%
C. 85%
- ACL surgery has a success rate of 95%
What is the role/function of the PCL in a kinematic open chain?
A. To prevent excessive posterior translation of the femur on the tibia
B. To prevent excessive posterior translation of the tibia on the femur
C. To prevent excessive anterior translation of the femur on the tibia
D. To prevent excessive anterior translation of the tibia on the femur
B. Prevent excessive posterior translation of the tibia on the femur
- In a closed chain where the foot is in contact with the ground and bearing weight, the PCL prevents the femur from translating anterior in respect to the tibia. However, in an open chain where the foot is not bearing weight the PCL prevents the tibia from translating posterior, especially when performing orthopedic testing on the ligament.