New York State Medical Treatment Guidelines for Posterior Cruciate Ligament (PCL) Injury in workers compensation patients

The New York State Workers Compensation Board has created guidelines for the treatment of Posterior Cruciate Ligament (PCL) Injury. These guidelines are designed to assist physicians, and healthcare professionals in figuring out the appropriate treatment for this condition.

Professionals in the healthcare field managing Posterior Cruciate Ligament (PCL) Injury can depend on these guidelines from the Workers Compensation Board to make informed choices about the best level of care for their patients.

It is crucial to emphasize that these guidelines should not act as a substitute for clinical judgment or professional expertise. The ultimate decision about care should be a collaborative effort, with the patient and their healthcare provider involved.

Description / Definition

Rupture of PCL may have concurrent ACL rupture.


Mechanism of Injury

Most often caused by a posterior directed force to flexed knee.


Specific Physical Findings

Findings on physical exam include acute effusion, instability, reverse Lachman’s test, reverse pivot shift, posterior drawer test.


Diagnostic Testing Procedures

MRI, Radiographs
Recommended – in select patients as clinically indicated and/or with suspicion of avulsed bone.


Non-Operative Treatment

Recommended – in select patients as clinically indicated.
Rest/restricted activity, off-loading with crutches or cane, ice, elevation, bracing, casting, orthotics, rehabilitation and active and/or passive therapy, NSAIDs, APAP and therapeutic injections.


Operative Treatment

Autograft or allograft reconstruction.
Recommended – in select patients as clinically indicated.
Indications: Complaints of instability. Carefully consider the patients’ normal daily activity level before initiation of surgical intervention. Most commonly done when the PCL rupture is accompanied by multiligament injury.


Post-Operative Therapy

Therapy, bracing.
Recommended – in select patients as clinically indicated.




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