Reintroduce at 6-12 weeks under physiotherapy guidance
Prone passive flexion technique
Gravity reduces posterior tibial sag in prone position
Supine flexion allows gravity to increase posterior sag
ICD-10 coding
S83.521A: Sprain of posterior cruciate ligament of right knee, initial encounter
S83.522A: Sprain of posterior cruciate ligament of left knee, initial encounter
S83.529A: Sprain of posterior cruciate ligament, unspecified knee, initial encounter
SNOMED CT
444798002: Injury of posterior cruciate ligament
Subcategory coding by severity and chronicity
Patient Discharge Instructions
copy discharge instructions
Diagnosis and injury explanation
You have a posterior cruciate ligament (PCL) tear in your knee
The PCL is a major ligament inside the knee that stabilizes the shin bone
Your injury has been graded based on physical examination and imaging
Most PCL injuries heal well with conservative treatment
Physiotherapy and quadriceps strengthening are the most important parts of recovery
Home care instructions
Apply ice to the knee for 20 minutes every 2 hours for the first 48-72 hours
Wrap ice in a cloth to protect the skin
Keep your leg elevated above heart level when resting
Reduces swelling and pain
Wear your knee brace or immobilizer as instructed
Keep the knee straight in the brace unless instructed otherwise
Use crutches to walk and bear weight as tolerated
Do not put full weight on the leg without crutches initially
Medications
Take ibuprofen (400-600 mg) or naproxen (500 mg) with food as directed
Do not exceed recommended doses
Acetaminophen 500-1000 mg every 6-8 hours as needed for additional pain relief
Do not take more than 4000 mg per day
Take any prescribed medications as directed
Activity restrictions
No sports, running, or jumping until cleared by your orthopedic specialist
Most isolated PCL injuries return to sport in 3-6 months
Avoid isolated hamstring exercises during early recovery
These increase strain on the healing ligament
Begin gentle quadriceps exercises as instructed by your physiotherapist
Follow-up appointments
Orthopedic or sports medicine appointment within 7-14 days
MRI may be arranged before or at this visit
Begin physiotherapy as soon as possible
A referral has been arranged or will be provided
Return to emergency department immediately for
Loss of pulse in the foot, coldness, or color change in the leg
Vascular emergency requiring immediate evaluation
Numbness, tingling, or weakness in the foot or lower leg
May indicate nerve injury
Increasing swelling, severe pain uncontrolled by medication
Calf pain and swelling suggesting blood clot (DVT)
Especially if on prolonged bed rest or immobility
Fever above 38.5 degrees Celsius or signs of infection at the knee
Inability to bear any weight on the leg
References
Guidelines and key sources
Harner CD, Hoher J. Evaluation and Treatment of Posterior Cruciate Ligament Injuries. American Journal of Sports Medicine. 1998. PMID: 9617416
Foundational review of PCL evaluation and management principles
Mechanism, diagnosis, grading, and treatment algorithm
Bedi A, Musahl V, Cowan JB. Management of Posterior Cruciate Ligament Injuries: An Evidence-Based Review. Journal of the American Academy of Orthopaedic Surgeons. 2016. PMID: 27097125
Evidence-based framework for conservative vs surgical decision-making
Rehabilitation principles and outcomes data
Badri A, Gonzalez-Lomas G, Jazrawi L. Clinical and Radiologic Evaluation of the Posterior Cruciate Ligament-Injured Knee. Current Reviews in Musculoskeletal Medicine. 2018. PMID: 29987531
Physical examination maneuvers with sensitivity and specificity data
Imaging modality comparison and grading systems
Wang D, Graziano J, Williams RJ, Jones KJ. Nonoperative Treatment of PCL Injuries. Current Reviews in Musculoskeletal Medicine. 2018. PMID: 29721691
Natural history of conservatively managed PCL tears
91% return to sport at same or higher level at 2 years
Gao S, Meng J, Zeng C, et al. Management of Posterior Cruciate Ligament Injuries: An Expert Consensus From 17 Countries. International Journal of Surgery. 2025. PMID: 40277372
Most recent international expert consensus on PCL management
Guidance on surgical indications for grade III injuries
Wang LY, Yang TH, Huang YC, et al. Evaluating Posterior Cruciate Ligament Injury by Using Two-Dimensional Ultrasonography and Sonoelastography. Knee Surgery, Sports Traumatology, Arthroscopy. 2017. PMID: 27145775
PCL thickness cutoff ≥ 6.5 mm with 90.6% sensitivity and 86.7% specificity
Schroven W, Vles G, Verhaegen J, et al. Operative Management of Isolated PCL Injuries Improves Stability and Reduces Secondary Osteoarthritis. Knee Surgery, Sports Traumatology, Arthroscopy. 2022. PMID: 34505176
Residual laxity 3.4 vs 5.5 mm; osteoarthritis 21.5% vs 44.1%
Kew ME, Cavanaugh JT, Elnemer WG, Marx RG. Return to Play After Posterior Cruciate Ligament Injuries. Current Reviews in Musculoskeletal Medicine. 2022. PMID: 36447081
Return to sport timeline and criteria
Quadriceps strength as primary functional marker
Knapik DM, Smith MV, Matava MJ, Brophy RH. Management of Posterior Cruciate Ligament Injury. Journal of the American Academy of Orthopaedic Surgeons. 2025. PMID: 41202194
Current indications, techniques, and outcomes overview 2025
Solomon DH, Simel DL, Bates DW, Katz JN, Schaffer JL. Does This Patient Have a Torn Meniscus or Ligament of the Knee? JAMA. 2001
Rational clinical examination meta-analysis
Sensitivity and specificity of posterior drawer and sag tests
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.