PCL Reconstruction — PCL and/or Posterolateral Corner (PLC) Reconstruction/Repair

University of Virginia Orthopaedic Surgery

Weight-Bearing

50% WB for 6 weeks

Key Restrictions

50% WB for 6 weeks; brace locked 0° weeks 0-2, unlocked 0-90° weeks 2-6; ALL ROM exercises prone or side-lying only first 6 weeks; NO hamstring isometrics; NO active strengthening with knee flexion; prevent posterior tibial translation and tibial rotation (paramount through 8 weeks); PCL/PLC fixation less sturdy than ACL fixation

Timeline & Phases

Phase 1 (0-6 wks): brace locked 0° then 0-90°, 50% WB, quad sets/SLR, NO HS isometrics, prone ROM only, Russian stim in extension; Phase 2 (6-10 wks): wean crutches to FWB, prone flexion 120°+, CKC, balance, step-ups, lateral stepping around week 8, HS curls 5 lbs max; Phase 3 (10-16 wks): lateral movements (supervised), jogging assessment at 12 wks (if full ROM/normalized gait/strength), isokinetics; Phase 4 (4-6 months): plyometrics, walk-jog, sport-specific supervised; Phase 5 (6+ months): full return, unrestricted lower body lifting ~10-12 months for athletes

Notes

NO hamstring isometrics in Phases 1-2 (protects PCL/PLC); ROM prone/side-lying only first 6 weeks; PCL/PLC fixation less sturdy than ACL — posterior translation prevention paramount through 8 weeks; HS curls limited to 5 lbs max in Phase 2; 10-12 months for full return to sport for athletes; isokinetic testing before full return (quad difference <15%, H:Q ratio 65%+)

Published

12/2024