A posterior cruciate ligament (PCL) reconstruction uses a graft to reconstruct the damaged ligament, often part of your hamstring tendons. The tendons are fed through the knee before tensioning and securing them to your shin bone. This is designed to mimic a normal PCL and provide better stability and balance mechanisms within the joint, thereby allowing you to return to higher level activities such as sports involving impact and rotation.

Phase oneThe first phase of your recovery will be focused on managing your swelling and pain and early mobilisation to prevent excessive knee stiffness developing. You will be provided with elbow crutches to help with balance and stability when weight-bearing and walking but under normal circumstances we will encourage you to take full weight through the knee as your pain and strength allow. Regular icing and compression of the knee is encouraged at this stage to improve swelling and bruising. Your physiotherapist will guide you through some initial activation exercises for your quadriceps and hamstrings which will help to support your knee and prevent excessive muscle wasting post-operatively. Regular stretching of the knee, particularly in to extension is encouraged.

Phase two

The second phase of your recovery will focus on enabling you to be able to walk with a more normal gait pattern, increase your knee range of motion as quickly as possible and strengthen your hip and knee muscles, particularly your quadriceps. Weaning off your elbow crutches is normally completed 2-3 weeks after surgery. Regular stretching of the knee in to extension and flexion is encouraged to regain full range of motion by 12 weeks post-surgery.

Once any acute pain from the surgery and significant knee joint swelling has recovered, your physiotherapist will prescribe more appropriate strengthening exercises. These exercises will involve gentle resistance/loading exercises for the quadriceps muscles to increase strength and control to support the PCL graft. Weight-bearing exercises such as wall slides, squats and lunges may commence gradually to begin strengthening your operated leg muscles in weight-bearing positions. You will be required to refrain from any rotational weight-bearing exercise or impact exercise until 12 weeks post-surgery, at which time your PCL graft should have secured itself and developed new capillary (blood supply) networks needed for longer term tissue strength.

Phase threeThe third phase of your recovery will begin at 12 weeks post-surgery. Typically, the initial part of this phase will involve commencing light impact work such as jogging on the treadmill and increasing the vigour of existing exercises such as specific quadriceps strengthening movements, squats, lunges and leg press. Your physiotherapist will guide you appropriately, but under normal circumstances, once the strength of your operated leg is equal to your non-operated leg, activity or sports-specific rehabilitation exercises can be commenced. This may include progression to sprinting, jumping and rotational movements depending on the sport desired.

The Game Ready Ice Machine, electric muscle stimulator, AlterG anti-gravity treadmill, Hydro Physio aqua-jogger, 3D Gait Analysis, sports exercise equipment such as the Concept2 rower, plus Circle’s Return to Sport Assessment Service may help rehabilitation following PCL reconstruction

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