This protocol applies to patients with an acute isolated posterior cruciate ligament (PCL) injury who are not young active patients. Injury severity is:
Evidence shows comparable outcomes between initial PCL reconstruction and conservative treatment at these grades, supporting a structured rehabilitation approach as the first-line strategy.
The approach centres on a supervised physiotherapy programme paired with a PCL knee brace and anti-inflammatory management, targeting key muscle groups to restore stability. The complete programme structure, progression milestones, and brace protocol are detailed in the full regimen.
PCL healing verified by clinical examination and/or stress radiograph at week 15.
DOI: 10.1097/JS9.0000000000002416
Considering limited studies showing comparable outcomes of initial PCL reconstruction and conservative treatment for grade I (1–5 mm posterior tibial translation) and grade II (6–10 mm posterior tibial translation) isolated PCL tear, we recommend supervised, structured, and accelerated rehabilitation protocol as a replacement for initial reconstruction.
Nonoperative therapy includes 3 months of supervised physiotherapy, anti-inflammatory medications, range-of-motion training, gradual strengthening of the quadriceps, hamstrings, hip adductors, and core muscles, and a progressive return to activity.
Rehabilitation involves using a knee brace to prevent tibial posterior displacement and lock the knee in full extension initially, followed by a functional brace for ligament insufficiency, allowing daily activities and progression to higher-level activities.
Usually after week 15, clinical examination and/or stress radiograph are performed to objectively verify the healing of PCL.