PCL Reconstruction
Posterior cruciate ligament (PCL) reconstruction replaces a torn PCL with a tendon graft to restore stability to the knee. The PCL is the strongest ligament in the knee, running diagonally inside the joint and preventing the tibia from sliding backward behind the femur. PCL injuries are less common than ACL tears and frequently occur from a direct blow to the front of the bent knee — a dashboard injury in a car accident, or a hard fall onto the knee in sports. Many PCL tears are treated conservatively, but significant instability or combined ligament injuries typically require reconstruction.
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Who Needs PCL Reconstruction?
PCL reconstruction is recommended for patients with complete PCL tears causing functional instability, or combined ligament injuries (PCL with ACL, PLC, or MCL involvement). Athletes wanting to return to cutting and pivoting sports are strong candidates. Isolated PCL injuries with mild to moderate laxity often do well with physical therapy alone; surgery is reserved for those who fail conservative management or have multi-ligament involvement.
What to Expect
Recovery Timeline
Brace locked in extension. Crutches with partial weight bearing. Ice and elevation critical.
Progressive weight bearing. Brace unlocked for range-of-motion work. Quadriceps activation exercises.
Full weight bearing. Stationary bike and pool work. Focus on quad and hamstring strength.
Jogging program begins if strength and proprioception are adequate.
Sport-specific training. Return to sport testing at 9 months.
Return to full competition for most athletes. Combined ligament reconstructions may take longer.
Risks & Complications
- Knee stiffness (arthrofibrosis)
- Graft failure or re-tear
- Continued posterior instability
- Popliteal artery or nerve injury (rare but serious with severe injuries)
- Infection
- Hardware irritation requiring removal
Frequently Asked Questions
Is PCL reconstruction as common as ACL surgery?
No. ACL tears are far more common, and many PCL tears are treated without surgery. The PCL has better blood supply than the ACL, which is why partial tears often heal on their own with physical therapy.
How long does PCL reconstruction recovery take?
Return to sport typically takes 9-12 months. The PCL reconstruction itself heals similarly to an ACL reconstruction — the graft goes through a ligamentization process that takes 9-18 months regardless of how the knee feels day to day.
Can a PCL tear heal without surgery?
Many can. Grade I and II PCL tears (partial tears with mild laxity) frequently respond well to aggressive physical therapy, particularly quadriceps strengthening. Grade III tears (complete ruptures) with significant instability are more likely to need surgery, especially in active patients.
Find a surgeon for PCL Reconstruction
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Search surgeonsEstimated Cost
$20,000 - $40,000 (before insurance). Multi-ligament knee surgery is higher. Covered by most insurance when functional instability is documented.
Full cost breakdownRelated Specialty
Sports Med Specialists →Other Procedures
This information is for educational purposes only. Costs are estimates and vary by location, surgeon, and insurance. Always consult a qualified healthcare provider.