PCL Knee Injury Specialist

Are you an athlete who participates in contact sports? If so, you may be at risk of sustaining a PCL injury. A PCL injury is caused by a powerful force to the front of the knee. This typically occurs from falling on a bent knee during a sporting activity. PCL tear 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 have sustained an PCL injury. Contact Dr. Williams’ team today!

What is an PCL Injury or Tear?

The posterior cruciate ligament (PCL) is one of the four major ligaments of the knee. Ligaments are sturdy bands of tissue that connect bones, make up the knee joint complex, and stabilize the knee. The posterior cruciate ligament, or PCL, prevents the femur (thigh bone) from sliding toward or off the front-facing edge of the tibia (shin bone). It also prevents the tibia from displacing backward toward the femur. The PCL allows the knee joint to flex, extend, and employ muscle power through the knee. It runs down the center of the knee from the back of the tibia to the front of the femur. A PCL tear typically occurs when there is a direct blow to the front of the knee, or by an impact that drives the tibia too far toward the knee.  Dr. Riley Williams is an orthopedic knee specialist serving Manhattan, Brooklyn, New York City, NY and surrounding areas. He has extensive experience and expertise in treating PCL injuries in the knee.


PCL Injury

How does a posterior cruciate ligament injury happen?

A PCL injury is a less common sports-related injury, making up less than 20% of knee ligament injuries. The severity of the injury ranges from a small strain to a complete tear. A stretch or tear is caused when the ligament is stretched beyond its normal range, and the tibia slides out from under the femur, shifting the patella (kneecap). Causes of PCL injury may include:

  • A direct blow to the knee while it is flexed or bent, as seen in contact sports such as football or soccer
  • A dashboard injury, when a car accident occurs and the knee suffers damage while in a bent position
  • Firmly planting the foot and pivoting
  • An awkward land from a jump
  • Sudden stopping
  • A sports collision or accident

Who is at risk for a posterior cruciate ligament (PCL) injury?

Posterior cruciate ligament injuries can happen to athletes of all ages and competitive levels. Less than 20% of all ligament injuries are PCL tears, making them a less common injury. There are a number of factors that increase the risk of an PCL injury, including:

  • Participation in contact sports. Contact sports such as football, soccer and basketball involve quick sudden directional changes. Non-contact sports like dance and skiing also involve a high risk of a PCL injury.
  • Manual labor jobs such as construction and landscaping involve squatting and heavy weight lifting, putting participants at risk for a PCL tear.
  • Other knee injuries. ACL and MCL tears can often be accompanied by a PCL tear.
  • Age can be a risk factor. While PCL injuries are seen in patients ages 18-44, older adults are at higher risk for a PCL tear than this age range.

What are the symptoms of an PCL injury?

Individuals in the New York area who experience a posterior cruciate ligament  injury often report the following symptoms:

  • Mild to moderate pain in the knee potentially causing a limp
  • Knee swelling within hours of the injury occurrence
  • Knee instability like feeling the knee will collapse
  • Trouble bearing weight on the knee

How is a PCL injury diagnosed?

Dr. Williams will inquire about the circumstances leading up to the injury and perform a physical exam of the injured knee. He will test the range of motion, look for swelling and assess the degree of pain. A “posterior drawer test” may be performed to confirm the diagnosis. During this test, Dr. Williams will push the shin back with the knee bent at 90 degrees. The PCL is likely torn if the tibia gives more than 5mm. An MRI may be requested which will allow Dr. Williams to visualize the structures inside the knee and assess the health of the PCL as well as the other ligaments.

What is the treatment for an PCL injury?

Not all PCL injuries require surgery. A strain or sprain can heal on its own with proper rehabilitation. The severity of symptoms and the condition of the PCL will determine if surgery is needed.

Non-surgical treatment of an PCL injury:

Initial treatment of both surgical and non-surgical PCL injuries follows the RICE method:

  • Rest the joint
  • Ice injury to reduce swelling
  • Compress swelling with a bandage
  • Elevate the injury

Dr. Williams could also recommend a non-steroidal anti-inflammatory drug such as ibuprofen to relieve any initial pain or swelling. If the injury’s severity determines the need for a splint, the knee will be splinted to keep it in a straight-leg position. This splinting combined with rehabilitation including physical therapy will strengthen the muscles around the knee, supporting the joint and preventing further injury.

Surgical treatment of an PCL injury:

A PCL tear that will not heal on its own indicates the PCL has been pulled away from the bone, causing either a severe or complete tear. Surgery is then needed to restore knee stability and function. Dr. Williams is very experienced and skilled at reconstructing and repairing the damaged PCL. The following surgical procedures may be used to repair the PCL:

  • Transtibial posterior cruciate ligament (PCL) reconstruction:
    • If the PCL has been pulled and detached from its anchor point, it can be reattached to the bone with a surgical screw, pin, or strong sutures. It is important that the reattachment follow the original footprint of the torn PCL.
    • Autograft: the PCL can be surgically reconstructed using a piece of the patient’s own tissue. The graft can be obtained from several sources including; bone-patellar tendon-bone (BTB) graft, hamstrings, or quadriceps tendon. The advantage of an autograft is that it uses the body’s own tissue, almost eliminating the risk of rejection.
    • Allograft: Tissue taken from a donor source, often a cadaver. Advantages of allografts include a quicker initial recovery and lower surgical morbidity of the graft.

For more information on an PCL injury or on a posterior cruciate ligament reconstruction, and the treatment options available, please contact the office of Riley J. 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