PCL Insufficiency Specialist

Have you had a prior injury to your PCL? Do you feel like your knee will not hold your weight, or that your knee is unstable? If so, you may have stretched or damaged your posterior cruciate ligament and are experiencing PCL insufficiency. PLC deficiencies can cause pain, especially under the kneecap or when climbing stairs. PCL insufficiency specialist, Doctor Riley J. Williams provides diagnosis as well as surgical and nonsurgical treatment options for patients in Manhattan, Brooklyn, New York City and surrounding areas who are experiencing symptoms of a PCL insufficiency. Contact Dr. Williams’ team today!

What is the PCL?

The PCL is also known as the Posterior Cruciate Ligament. The PCL is one of two internal knee ligaments, and is located in the center of the knee just opposite to the ACL (Anterior Cruciate Ligament). The connects the femur (thigh bone) to the tibia (shin bone) inside the knee joint. The job of the posterior cruciate ligament is to keep the knee stable during typical knee movements; the PCL keeps the tibia from moving backwards relative to the femur. Excessive motion between the tibia and femur, associated with a PCL deficient knee, causes knee dysfunction and knee instability. PCL insufficiency specialist, Doctor Riley J. Williams has extensive experience treating patients in Manhattan, New York City and surrounding New York boroughs who are suffering from the symptoms of PCL insufficiency.

What is a PCL insufficiency?

A PCL insufficiency occurs when the posterior cruciate ligament does not stabilize the knee properly. A damaged, stretched or torn PCL can lead to a PCL insufficiency, where the stabilization of the knee is compromised. PCL insufficiencies are most often seen in athletes who play contact sports (Football, soccer, lacrosse, rugby). Car accident – dashboard injuries, that result a direct blow to the knee (from the front) can also injury the knee and cause of a PCL tear.

What are causes of a posterior cruciate ligament insufficiency?

There are several possible causes of a PCL insufficiency, which may include:

  • Prior injury to the PCL
  • An avulsion fracture or injury to the bone-ligament attachment, where the PCL attaches to the tibia
  • Injury to other ligaments in the knee, such as the ACL, Medial Collateral Ligament (MCL), Lateral Collateral Ligament (LCL) or Posterolateral Corner (PLC) complex
  • An Isolated PCL injury without other knee damage

What are symptoms of an insufficient or deficient PCL?

Patients with a PCL insufficiency often cannot recall the mechanism of injury. Common symptoms are:

  • Pain when flexing or fully extending the knee
  • Pain with weight bearing
  • Knee pain when climbing stairs or squatting
  • Ache in the knee joint after walking long distances
  • Feeling the knee will give way or move out of joint
  • Pain felt under the kneecap
  • Frank knee shifting or instability with pivoting or rotational maneuvers

How is a PCL insufficiency diagnosed?

Dr. Williams will obtain a detailed history to understand the nature of symptoms and mechanism of injury, past trauma to the knee and current complaints. He will conduct a physical exam to see if the knee is unstable using specific tests designed to detect PCL deficiency. Often an MRI Scan is required to see the interior structures of the knee and to judge the health of the posterior cruciate ligament.

What is the treatment for a PCL insufficiency?

Non-surgical treatment:

Non-operative treatment for a PCL insufficiency is usually reserved for low-grade sprains of the PCL that do not result in knee instability symptoms. Dr. Williams will conduct several diagnostic tests to determine the best course of treatment. Conservative treatment may include anti-inflammatory medication, rest, bracing and physical therapy.

Surgical treatment:

The goal of surgical treatment for a PCL insufficiency is to reconstruct the ligament and restore normal knee function and stability. Dr. Williams will discuss with his patients in New York and the surrounding areas the best treatment options including possible tissue grafts to replace the PCL. These grafts may include:

  • Autograft – Tissue obtained from the patient
  • Allograft – Tissue obtained from a donor or cadaver

Typical PCL reconstruction surgeries are arthroscopic or minimally invasive. These procedures are typically done on an outpatient basis, and take approximately an hour to perform.

How long is the recovery after PCL insufficiency surgery?

Dr. Williams will have a specific post-surgical protocol that needs to be followed to insure the best possible outcome of the procedure. For healthy, active patients without underlying medical problems, rehabilitation typically takes about 6-9 months.

For more information on PCL insufficiency, knee pain or knee instability, as well as the different treatment options available, please contact the office of Riley Williams, MD, knee specialist serving Manhattan, Brooklyn, New York City, NY and surrounding areas.  


HSS Sports Medicine Institute West Side
610 W 58th Street
New York, NY 10019

HSS Brooklyn
148 39th Street, 7th Floor
Brooklyn, NY 11232

Office Hours

Monday-Friday: 9:00 am – 4:30 pm
Fax: 212-774-2895