Mechanisms of Injury in the PCL
HIDEInteractive Transcript
0:00
With regard to causes of tearing
0:03
of the posterior cruciate ligament.
0:06
This chart taken from the recent or
0:09
or literature not so recent, major causes
0:13
soccer shown in red
0:15
and unknown causes shown in dark blue.
0:20
Now, I can tell you that one
0:22
of the interesting causes seen in Asian countries in
0:26
particular, and I think described mainly in island, is
0:30
what is the Honda need,
0:32
and it relates to two individuals
0:35
traveling along the central portion of their lanes,
0:40
colliding their knees colliding,
0:42
producing posterior translation of the tibius,
0:46
and resulting in the tears
0:48
of their posterior cruciate ligament.
0:51
With regard to specific mechanisms, again, there are many,
0:55
two of the important ones being dashboard injuries
0:59
and a fall on a flex knee.
1:02
Typically, a posterior force placed on a flex knee
1:06
when there's plantar flexion
1:09
of the foot is a characteristic injury pattern
1:12
for the posterior cruciate ligament.
1:15
Here you can see also a fall on the flex knee, again,
1:18
with plantar flexion.
1:20
When you fall on the flex knee
1:22
and the foot is not plantar flex.
1:24
More often there are injuries to bones
1:27
and other structures of the knee.
1:29
Hyperflexion can lead to an avulsion fracture
1:33
of the posterior cruciate ligament,
1:36
and then a very important mechanism seen in American
1:39
football, a posterior force supplied in this particular
1:43
manner to a hyperextended knee, often leading
1:47
to a combination of posterior
1:50
and poster lateral uh injuries.
1:54
We can look for the typical footprints left behind here,
1:59
a posterior cruciate ligament tear.
2:01
There was also a tear
2:02
of the anterior cruciate hyperextension
2:05
with a typical pattern of contusions
2:08
and fracture on the anor aspect of the femur and tibia.
2:13
And here a contusion left behind
2:17
by a external force supplied to the proximal aspect
2:21
of the tibia with a tear of the posterior cruciate ligament
2:25
and disruption of the posterior capsule.
2:29
Another example here with an external force shown by the
2:34
red arrows leading to a tear posterior translation
2:38
of the tibia and a tear of the posterior cruciate ligament.
2:45
When we deal with a posterior force applied
2:48
to a hyperextended knee in this particular fashion,
2:52
often you get associated injuries
2:54
to the postal lateral corner of the knee. I show
2:58
You one case here using colored arrows to point out
3:02
with the yellow arrow, the PCL partial uh,
3:06
tear partial avulsion,
3:08
approximately the orange arrow showing you a partial tear
3:12
involving the anterior cruciate ligament.
3:15
The green arrows pointing to injuries of the fibula,
3:20
collateral ligament and tendon of the biceps femorals,
3:23
and the red arrows pointing to the footprints left behind
3:27
by the external force.
3:30
I show you one further example, the red arrows pointing
3:33
to the external force, the green arrows.
3:37
In this particular example showing you the injury involving
3:41
the postal lateral corner, you're going
3:44
to hear more about injuries
3:45
to the lateral supporting structures by Brady Wong
3:49
to in tomorrow's lectures I.
Donald Resnick, MD
Professor Emeritus, Department of Radiology
University of California, San Diego
Mini N. Pathria, MD, FRCP(C)
Division Chief, Musculoskeletal Imaging
University of California San Diego
Eric Y. Chang, MD
Adjunct Professor, Radiology
University of California, San Diego
Brady K. Huang, MD
Clinical Professor of Radiology
UC San Diego Medical Center
© 2026 Medality. All Rights Reserved.
