Ace Physiotherapy and Sports in Singapore
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+65 81535374 -
ACE PHYSIO SPORTS
East gate Building, 46 East Coast Road
#08-03 Singapore 428766 -
Opening Hours
Mon to Fri: 08:00am - 8:00pm -
Opening Hours
Sat: 08:00am - 4:00pm
Sunday (By prior appointment)
Posterior Cruciate Ligament (PCL)
What is Posterior Cruciate Ligament (PCL) Surgery?
Posterior cruciate ligament (PCL) surgery involves the reconstruction or repair of the PCL, which may be necessary if the ligament is injured or torn. PCL injuries typically occur due to a direct impact to the tibia (shin bone) while the knee is bent, forcing the tibia backward against the femur (thigh bone). Such injuries can result from sports activities, falls, trauma, or motor vehicle accidents.
Unlike an anterior cruciate ligament (ACL) injury, which often causes the knee to “give way,” a PCL injury usually leads to deep pain at the back or inside of the knee. In severe cases, such as a complete tear, the knee may become unstable. Since the PCL does not heal effectively on its own, surgical reconstruction is often required.
PCL reconstruction replaces the damaged ligament with a graft, commonly taken from the Achilles tendon, to restore knee stability and function. Surgery is usually performed using arthroscopic (keyhole) techniques, allowing the surgeon to evaluate the entire knee joint and repair or reconstruct any damaged tissue through small incisions.
When combined with a structured physiotherapy programme at Ace Physio Sports, PCL surgery can help patients achieve near-normal knee function, regain strength, and safely return to work, daily activities, hobbies, and sports.
PCL Surgery Options
When undergoing PCL reconstruction, several surgical options and techniques are considered to ensure optimal knee stability and function. These include graft choices, donor sites, fixation methods, and graft bundles.
1. Graft Choices
The graft is the tissue used to replace the injured PCL and can be:
- Autograft – tissue taken from another part of your own body
- Allograft – tissue donated from another person
- Synthetic – artificial graft material
2. Donor Sites
The graft can be harvested from various parts of the body, depending on the surgeon’s preference and patient factors:
- Bone-Patellar Tendon-Bone (BPTB)
- Quadrupled Hamstrings (Semitendinosus & Gracilis)
- Quadriceps Tendon
- Achilles Tendon
- Fascia Lata
3. Graft Fixation
The graft is secured to the knee using different fixation methods to ensure stability while healing:
- Screws (biodegradable or metallic)
- Transfix Pins
- Crosspin / Transfix
- Endobutton Loop
- Scaffold / Matrix
4. Bundles
The graft may be prepared as either:
- Single Bundle – less expensive, shorter surgery time
- Double Bundle – more expensive, provides a more anatomical reconstruction resembling the ACL for improved knee stability
Pre-Surgery Physiotherapy for PCL Surgery
Physiotherapy should begin as soon as a PCL injury occurs. At Ace Physio Sports, early physiotherapy focuses on reducing pain and swelling, restoring range of motion (ROM), and preparing the knee for potential surgery.
The main goals of pre-surgery physiotherapy are to:
- Strengthen the muscles around the knee to support stability
- Regain as much knee mobility as possible
- Reduce pain and swelling
- Strengthen surrounding joints, including the hip and ankle, to provide additional support
- Maximise weight-bearing capacity, if safe, to maintain functional independence
Our physiotherapists create a personalised pre-operative programme tailored to your injury and physical condition, ensuring your knee is optimally prepared for surgery and improving post-operative recovery outcomes.
Symptoms post surgery
Following PCL reconstruction surgery, it is common to experience:
- Pain and swelling around the knee
- Stiffness and reduced range of motion
- Muscle weakness and decreased control around the knee
- Loss of proprioception (balance and joint awareness)
After surgery, you will typically be provided with crutches, as full weight-bearing may be restricted for up to 6 weeks to protect the graft and allow proper healing. A knee brace may also be prescribed for approximately 3 weeks to provide additional support and stability. During this period, you will generally be unable to drive until you can safely bear weight on your knee and have regained adequate mobility.
Physiotherapy After PCL Surgery
A structured physiotherapy programme is essential immediately following PCL reconstruction surgery to restore full knee function, strength, and stability. Rehabilitation at Ace Physio Sports is carefully phased to match the healing process and the patient’s functional recovery.
Early Stage: 0–2 Weeks
The first two weeks focus on tissue healing, pain and swelling reduction, circulation, and regaining confidence and independence. During this period, you will still rely on elbow crutches and a knee brace.
Exercises may include:
- Isometric quadriceps contractions
- Patella mobilisations
- Circulation exercises
- Hip and gluteal strengthening
- Core activation (abdominal tensing)
- Gentle flexibility and stretching exercises
- Upper body strengthening
Progression Stage: 2–4 Weeks
The focus during weeks 2–4 is on muscle strengthening, gait re-education, and proprioception while continuing the early-stage exercises.
Exercises may include:
- Continued early-stage exercises
- Gait training
- Quadriceps and hamstring strengthening with resistance as tolerated
- Proprioception and balance exercises
- Straight leg raises
Intermediate Stage: 4–6 Weeks
Weeks 4–6 aim to enhance muscle strength, promote normal gait, improve proprioception, and introduce aerobic conditioning. By the end of this phase, most patients should move independently without aids.
Exercises may include:
- Static cycling with gradual resistance increase
- Stepper and rower exercises as tolerated
- Continuation of previous strengthening, stretching, and balance exercises
Advanced Stage: 6–12 Weeks
This stage focuses on maximising knee range of motion, strength, power, endurance, and normal gait patterns.
Exercises may include:
- Gait re-education
- Quadriceps and hamstring strengthening with resistance
- Proprioception and balance training
- Static cycling and stepper exercises
- Rower training with increased resistance/duration
Functional Stage: 3–6 Months
From 3 to 6 months, rehabilitation emphasizes lower limb balance, functional strength, cardiovascular fitness, and gradual introduction to sport-specific movements.
Exercises may include:
- Swimming or hydrotherapy (excluding breaststroke)
- Early plyometrics (jumping)
- Agility exercises (direction changes)
- Continuation of gait, strength, and proprioception exercises
Summary
A PCL injury or tear causes knee pain and instability. PCL surgery reconstructs or repairs the torn ligament, restoring stability and preventing further damage to the knee, including the risk of osteoarthritis. Combined with a structured physiotherapy programme at Ace Physio Sports, PCL reconstruction allows a near-normal knee, enabling a safe and effective return to daily activities, work, hobbies, and sports.
To arrange an appointment, please call +65 81535374 or visit acephysiosports.com.
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