Physical therapy and RICE are the first-line treatments for PCL injuries. Prolotherapy is also an option in less severe cases, but where ligaments are more severely damaged, PRP and/or bone marrow concentrate (containing stem cells) may be called for as the next nonsurgical treatment option.
Platelet-Rich Plasma for PCL Tears & Sprains
“PRP” is short for platelet-rich plasma, and it is autologous blood with concentrations of platelets above baseline values (1). Platelet-rich plasma (PRP) has been growing in popularity since it was discovered to have the potential to improve overall joint function, decrease pain and inflammation, and help the body repair itself via injections into damaged or diseased joints. PRP treatments are a type of regenerative medicine that uses your blood’s healing factors to help the body heal itself by injections of PRP into injured tissues. It is commonly used in regenerative orthopedic therapies for muscular strains or tears, ligament tears, tendon ruptures, minor arthritis, and joint instability.
PRP treatment with physical therapy can be a great solution for people who have suffered a grade 1 or 2 PCL tear or PCL sprain. These ligament injuries are typically diagnosed with the following grades of severity in mind:
Grade 1 Tears
A partial-thickness PCL tear is where only a portion of the PCL is torn. On ultrasound or MRI, a portion of the PCL would be torn but the remaining fibers would be normal.
Grade 2 Tears
A grade 2 PCL tear involves a tear that extends across the entire PCL and therefore is referred to as a full-thickness tear. The ligament has not pulled apart or snapped back upon itself and therefore is referred to as non-retracted. These types of tears can be treated with ultrasound-guided PRP or bone marrow concentrate.
Grade 3 Tears
A grade 3 tear is a full-thickness tear that extends across the LCL and, unlike a Grade 2, the ligament has pulled apart. This means that the two pieces of the ligament have pulled apart or maybe even snapped back like a rubber band. This type of tear requires surgery.
When Surgery Is the Only Option
People with grade 3 ligament injuries should avoid PRP injections because they are generally severe enough to require surgery.
Why Regenexx PRP Mixtures Are Superior
In most clinics that offer PRP therapies, the method of developing PRP involves removing a patient’s blood and running it through a simple bedside centrifuge machine to separate the plasma and concentrate the blood platelets, which are then immediately extracted and used as the injectate. These devices are not great at getting rid of unfavorable cells from the resulting mixture. Our lab tests show that white and red blood cells have an inhibiting effect on the same stem cells the platelets are attempting to stimulate and might cause excessive inflammation following the injection.
Our PRP is purer, concentrated, and customizable because it is produced in a laboratory setting by an experienced technician who can separate and concentrate all the blood’s good components and remove the unfavorable ones.
Invented at Centeno-Schultz Clinic, Regenexx’s Super Concentrated PRP procedures are an advanced type of PRP therapy that uses lab-processed PRP mixtures that have been found to provide up to 10 – 40 times more platelet concentrations than the traditional “bloody” PRP. Our PRP, due to its high levels of platelets, has an amber color (see Figure 1). Regenexx is the optimal choice of PRP for PCL tears and sprains.
Doctors that Treat PCL Injuries with PRP Injections
Christopher J. Centeno, M.D. is an international expert and specialist in Interventional Orthopedics and the clinical use of bone marrow concentrate in orthopedics. He is board-certified in physical medicine and rehabilitation with a subspecialty of pain medicine through The American Board of Physical Medicine and Rehabilitation. Dr. Centeno is one of the few physicians in the world with extensive experience in the culture expansion of and clinical use of adult bone marrow concentrate to treat orthopedic injuries. His clinic incorporates a variety of revolutionary pain management techniques to bring its broad patient base relief and results. Dr. Centeno treats patients from all over the US who…
My passion and specialization are in the evaluation and treatment of cervical disc, facet, ligament and nerve pain, including the non-surgical treatment of Craniocervical instability (CCI). I quit a successful career in anesthesia and traditional pain management to pursue and advance the use of PRP and bone marrow concentrate for common orthopedic conditions. I have been a patient with severe pain and know firsthand the limitations of traditional orthopedic surgery. I am a co-founder of the Centeno-Schultz Clinic which was established in 2005. Being active is a central part of my life as I enjoy time skiing, biking, hiking, sailing with my family and 9 grandchildren.
Dr. Pitts is originally from Chicago, IL but is a medical graduate of Vanderbilt School of Medicine in Nashville, TN. After Vanderbilt, he completed a residency in Physical Medicine and Rehabilitation (PM&R) at Emory University in Atlanta, GA. The focus of PM&R is the restoration of function and quality of life. In residency, he gained much experience in musculoskeletal medicine, rehabilitation, spine, and sports medicine along with some regenerative medicine. He also gained significant experience in fluoroscopically guided spinal procedures and peripheral injections. However, Dr. Pitts wanted to broaden his skills and treatment options beyond the current typical standards of care.
Post-residency, Dr. Markle was selected to the Interventional Orthopedic Fellowship program at the Centeno-Schultz Clinic. During his fellowship, he gained significant experience in the new field of Interventional Orthopedics and regenerative medicine, honing his skills in advanced injection techniques into the spine and joints treating patients with autologous, bone marrow concentrate and platelet solutions. Dr. Markle then accepted a full-time attending physician position at the Centeno-Schultz Clinic, where he both treats patients and trains Interventional Orthopedics fellows. Dr. Markle is an active member of the Interventional Orthopedic Foundation and serves as a course instructor, where he trains physicians from around the world.
Doctor Hyzy is Board Certified in Physical Medicine and Rehabilitation (Physiatry) and fellowship-trained in Interventional Orthopedics and Spine. Dr. Hyzy is also clinical faculty at the University of Colorado School of Medicine in the Department of Physical Medicine and Rehabilitation; In addition, Dr. Hyzy is an Adjunct Clinical Assistant Professor at The Rocky Vista University College of Osteopathic Medicine. Dr. Hyzy also maintains an active hospital-based practice at Swedish Medical Center and Sky Ridge Medical Center. He is also recognized and qualified as an expert physician witness for medical-legal cases and Life Care Planning. He is published in the use of autologous solutions including…
Dr. Money is an Indiana native who now proudly calls Colorado home. He attended medical school at Kansas City University and then returned to Indiana to complete a Physical Medicine and Rehabilitation residency program at Indiana University, where he was trained on non-surgical methods to improve health and function as well as rehabilitative care following trauma, stroke, spinal cord injury, brain injury, etc. Dr. Money has been following the ideology behind Centeno-Schultz Clinic and Regenexx since he was in medical school, as he believed there had to be a better way to care for patients than the status quo. The human body has incredible healing capabilities…
The Posterior Cruciate Ligament is one of the paired ligaments in the middle of the knee. It is made up of 2 separate bundles: The two bundles of the PCL, and the ALB (anterior lateral bundle), and the PMB (posterior medial bundle), function synergistically to provide stability. The PCL functions as one of the main stabilizers of the knee joint and serves primarily to resist excessive posterior translation of the tibia relative to the femur. The PCL also acts as a secondary stabilizer of the knee preventing excessive rotation specifically between 90° and 120° of knee flexion. A PCL sprain happens when force is applied beyond…
The Posterior Cruciate Ligament (PCL) is a paired ligament in the middle of the knee. It is made up of two separate bundles: ALB (anterior lateral bundle) and PMB (posterior medial bundle). These bundles work synergistically to provide stability. The PCL plays an important stabilizing role in the knee joint by resisting excessive posterior translation of the tibia relative to the femur. Between 90 and 120 degrees of knee flexion, it serves as secondary support for preventing excessive rotation. PCL tears happen when force is applied beyond what the PCL tensile strength is capable of resisting. The tensile strength of the PCL is well documented…