Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents for follow-up of a chronic left knee injury. History is consistent with a remote posterior cruciate ligament (PCL) injury. Patient reports persistent posterior knee discomfort, occasional sense of instability during deceleration or stair descent, and chronic dull aching. Denies acute trauma, locking, or mechanical symptoms. Symptoms are stable but limiting to high-impact activities.
Clinical Examination Findings
Left knee examination: No acute swelling or effusion. Posterior sag sign is positive (Grade I/II). Posterior drawer test is positive with a soft endpoint. Lachman and anterior drawer tests are negative. Varus/valgus stress tests are stable. Range of motion is full but associated with mild discomfort at terminal flexion. Neurovascular status is intact distally.
Treatment Protocol
Conservative management plan: Continue physical therapy focusing on quadriceps strengthening and hamstring stabilization. Activity modification to avoid high-impact pivoting or contact sports. Consider hinged knee bracing for symptomatic instability. NSAIDs as needed for pain management. Follow up in 3-6 months or sooner if symptoms worsen.