What is the difference between ACL and PCL injuries?

The ACL and PCL are both important ligaments inside the knee, but they control movement in different directions.

The ACL prevents the shin bone from moving too far forward, while the PCL prevents it from moving too far backward.

ACL injury

• More common in sports.
• Frequently occurs during pivoting, twisting, or awkward landing.
• A popping sensation may occur.
• Rapid swelling is common.
• Patients often notice instability when changing direction.

PCL injury

• Less common than an ACL injury.
• Often caused by a direct blow to the front of the shin while the knee is bent.
• Common mechanisms include road accidents or falling onto a bent knee.
• Symptoms can sometimes be less obvious initially.
• Severe injuries can cause backward instability of the knee.

Both ligaments can be injured together in significant knee trauma, and meniscus or other ligament injuries may occur at the same time.

A physical examination together with imaging helps determine which structures have been damaged. Dr. Atul Mishra uses the pattern of instability, injury mechanism, examination findings, and imaging to distinguish between ACL, PCL, and combined ligament injuries before deciding on treatment.