PCL Surgery in Delhi

• Grade 1 partial tear of PCL is present, and the shin bone remains in front of the thigh bone.
• Grade 2 complete isolate tear of PCL with shin bone and thigh bone remains in line.
• Grade 3, there is a complete tear of PCL with injury to other structures, including the capsule and another ligament (acl/ plc injury) of the knee joint. The shin bone lies behind the thigh bone.

• Pain behind the knee joint
• instability/ difficulty maintaining balance at the knee joint in cases of severe injury.
• Swelling of the knee joint.
• Problem in walking downstairs.
• Difficulty in walking and playing sports 

It depends on the severity of the injury and the patient's daily activities. In cases where PCL injury is grade 1 or 2, and the patient has a desk job, no hard work, no sports activities, and no gym, the patient will be able to walk. But if the patient has a grade 3 injury/is required to do a field job, heavy activities, or play sports, there will be difficulty in walking.

Surgeons will perform some clinical tests apart from that x-rays, MRI and in a few cases, CT SCAN will be required.

• In most cases of grade 1 and grade 2
• Ice packing of the knee joint
• Use of knee braces to prevent movement at the knee joint
• Use of crutches may be provided
• Physiotherapy to regain entire movement

• Grade 3 PCL injury, i.e., PCL injury with other ligaments (ACL/ Posterolateral Complex) injury
• Grade 3 PCL injury with MEDIAL COLLATERAL LIGAMENT/ LATERAL COLLATERAL LIGAMENT injuries
• GRADE 2 or 3 injuries with bone avulsion
• Chronic PCL injuries with unstable knee joints.

The absence of the posterior cruciate ligament leads to increased pressure in the knee joint, which may lead to arthritis at an early age.

In bone avulsion, if the bone fragment is large, it is reduced to its original position, and fixation is done with screws. If the bone fragment is small, PCL reconstruction is done in bone avulsion.

In cases of PCL injury, the surgery done is PCL reconstruction.

In PCL reconstruction surgery, graft is taken from the patient's body and placed in the position where the original PCL was present. The graft is fixed with the help of fixation devices.

The success rate of PCL reconstruction depends on

• Proper graft positioning is of utmost importance. Most cases of reinjury or failure reconstructions occur due to wrong or misplaced positions of tunnels inside the femur or tibia bone. A good surgeon always focuses on making the tunnel accurate, as differences in position (in millimetres) can cause increased failure rates.
• We also preserve a sleeve of previously torn PCL as it helps preserve proprioceptive nerve endings, making post-surgical healing natural and resulting in complete natural recovery. Preserving original PCL tissue also helps reduce the chances of reinjury and prevents osteoarthritis.
• Ligament is secured in place with the help of fixation devices.

Fixation devices most commonly used are buttons and screws in PCL reconstruction surgery.

Button with threads attached to them used in PCL reconstruction surgery fixes graft to femur and tibia. These can be from different companies and are used depending on surgeons' preferences. Most commonly used to attach the graft to the femur/ thigh bone.

Screws used in PCL reconstruction surgery can be bioabsorbable or hydroxyapatite coated.

• Bioabsorbable screws are one that dissolves inside the bone. These screws are usually absorbed within 2 years and don't cause inflammation, clinical problems, or reactions. But further studies are required to know about detailed properties.
• Hydroxyapatite-coated screws.

Hydroxyapatite is naturally present in the bone and teeth of humans up to 50% volume and 70% weight.

• Screws coated with hydroxyapatite have a natural tendency to fix the bone.
• They also help in increased bone formation and better healing.
• Reduces infection risk
• Fewer chances of allergies or other sensitivities
• Better for x-ray and other imaging as they are radiopaque hence better visibility.

The ultimate decision of choosing between types of screws should be taken in consultation with the surgeon.

Complications include

• Infection
• Blood clots
• Persistent pain
• Stiffness

In case of any discharge from the wound, extreme pain, or fever, contact your doctor immediately.

Unlike ACL tears in PCL injury, some healing may occur independently. PCL tear of grades 1 and 2 may heal alone, but it requires proper rest and immobilization. Treatment depends on the grade and activity level of the person, as discussed before.

PCL reconstruction surgery usually takes 1 hour, but in cases where there are other ligament injuries, extra time is spent constructing those ligaments.

In worldwide studies, the success rate of PCL reconstruction surgery is 90%.

The PCL reconstruction surgery recovery time is longer than ACL reconstruction. After PCL reconstruction surgery, patients need more extensive rehabilitation programs than ACL reconstruction. The patient may require 4- 6 weeks of brace support and may require non-weight bearing followed by a program where full weight bearing with physiotherapy is started.

The patient will be able to shower as we use waterproof dressing after 2-3 days. But to take a bath, a patient will usually require 3-4 weeks.

The patient will have to remain non-weight bearing for 4- 6 weeks, depending on the severity of the injury.

Patients will usually be able to drive after 8-12 weeks after PCL reconstruction surgery.

Usually, the patient requires 8-12 months after PCL reconstruction surgery to return to sports. The recovery time of PCL reconstruction takes more time than ACL reconstruction surgery.

It depends on the hospital category chosen by patients and the type of implant which is discussed. At Simpainortho.com, we have tried to reduce the cost of surgery and hospital expenses and included complete after-surgery services, which patients require after surgery because we know treatment doesn't end at the patient's discharge. To ensure the quick recovery of patients in simpainortho.com, a patient requires expert care within the most comfortable surroundings until he can join routine activities. So, we have made different packages for different patients according to need, and that too at the most affordable prices.

Yes, most of the insurance has included PCL reconstruction surgery.