In our monographic master’s thesis, we used a descriptive method for collecting, reviewing and thorough analysis of papers and results of treatment and rehabilitation of patients with posterior cruciate ligament (PCL) injury. We created a database from the national and foreign literature and included our own experience in treating these types of injuries.
The knee is the largest and the most complex joint of the human body. The shape of joints does not significantly contribute to their stability; however, it does enable multidirectional knee movement. The articular capsule and ligaments are mainly responsible for static stability and exposed to injuries due to forces acting along the long bones of the lower extremities and causing large moments in the knee area due to increased moment arm. PCL injury is approximately ten times rarer than the anterior cruciate ligament (ACL) injury. The most frequent mechanism of PCL injury is a blow to the upper part of the shin, but the injury may also be caused during hyperextension of the knee or a fall on a contracted knee.
PCL injury can be treated conservatively or surgically, depending on the place and degree of injury. Isolated acute PCL injury in a stable knee is generally treated conservatively, because it is rarely clinically significant. Surgical treatment of PCL is indicated in obvious and larger knee instability. The modern principles of treating PCL injuries at large centers primarily focusing on managing injuries in performance athletes demonstrate a strong preference for surgical reconstruction based on studies indicating better anatomical conditions of the knee joint, more successful rehabilitation and greater likelihood of return to the training load in professional sport. If a surgical reconstruction of PCL is performed, knees have to be protected for 4-6 weeks with a flexible knee support, which relieves the knee by pushing the shin forward. A common characteristic of surgically and conservatively treated injured persons is optimal rehabilitation for re-establishing joint mobility in strengthening the muscles serving as knee stabilizers.
By reviewing the literature, we have identified significant discrepancies regarding surgical or conservative treatment of PCL injuries. Gaining knowledge and better comprehension of biomechanics over the last few years has provided an insight into the fact that inadequately treated PCL injury leads in large number of cases to serious subsequent consequences.
We have further concluded that despite an established protocol for the rehabilitation of patients, numerous approaches found in literature regarding the onset, performance and progression of rehabilitation exercises remain fragmented and inconclusive.
Three main objectives were set in this master’s thesis; to analyze previously published papers and protocols on treating and rehabilitation of PCL injuries, to present our own specific protocol of rehabilitation based on the review and analysis of a large portion of scientific contributions in the field of PCL injuries, and present in detail the course of rehabilitation with images of different exercises.
Based on the collected data and proper statistical analysis, we have highlighted certain ambiguities in treating athletes with PCL injuries. By setting up a protocol and defining a thorough and time-bound gradual rehabilitation, we have presented the role of the kinesiologists in the early rehabilitation process, who may use their knowledge and specific exercises to significantly contribute to an optimal rehabilitation of the injured person.
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