Лучшие больницы для «Posterior Cruciate Ligament (PCL) Surgery» в Мумбаи, Индия

The posterior cruciate ligament is the strongest ligament in the knee, running from the posterior tibia to the medial femoral condyle and serving as the primary restraint against posterior tibial translation. It also contributes to rotational stability, making its integrity essential for activities requiring deceleration, pivoting, and impact absorption. PCL injuries are graded on a I–III scale based on posterior tibial displacement: Grade I (0–5 mm), Grade II (6–10 mm), and Grade III (>10 mm, often indicating a combined ligamentous injury involving the posterolateral corner or ACL). Isolated Grade I and II tears are typically managed conservatively with structured physiotherapy, quadriceps-strengthening protocols, and bracing; however, Grade III tears, multi-ligament knee injuries (MLKI), and symptomatic Grade II tears that have failed 3–6 months of rehabilitation are standard indications for surgical reconstruction.

• ELIGIBLE CANDIDATES:
• Confirmed Grade III PCL tear (posterior tibial translation >10 mm on stress radiographs or KT-1000/KT-2000 arthrometer testing) with functional instability
• Grade II PCL tear with documented failure of structured conservative management (minimum 3–6 months of quadriceps-focused rehabilitation)
• Multi-ligament knee injury (MLKI) involving the PCL in combination with ACL, posterolateral corner (PLC), or posteromedial corner (PMC) pathology
• Symptomatic PCL-deficient knee in active individuals aged 15–55 years (athletic or high-demand occupational requirements)
• +17 more

GRAFT Selection AND Technique OPTIONS:

1. ARTHROSCOPIC SINGLE-BUNDLE PCL RECONSTRUCTION (ANTEROLATERAL BUNDLE FOCUS)

The most widely performed technique. A central graft tunnel is drilled at the native PCL femoral footprint on the medial femoral condyle, and the tibial tunnel is placed at the anatomic tibial PCL footprint (approximately 1 cm below the joint line on the posterior tibia). Graft options include:

• Bone-Patellar Tendon-Bone (BPTB) Autograft: Gold standard for high-demand athletes; bone plugs allow robust interference screw fixation and early bone-to-bone healing. Donor site morbidity includes anterior knee pain (up to 15–20%).
• Quadriceps Tendon Autograft (with or without patellar bone plug): Increasingly favored; larger cross-sectional area than hamstring grafts, lower donor site morbidity than BPTB, and biomechanical properties closely matching the native PCL.
• Hamstring Tendon Autograft (4-strand semitendinosus/gracilis): Lower donor site morbidity; commonly used in patients who require preservation of the patellar tendon for prior procedures. Graft diameter target ≥8 mm.
• Achilles Tendon or Tibialis Anterior Allograft: Preferred in revision cases, multi-ligament reconstructions, or when autograft harvest is contraindicated. Eliminates donor site morbidity but carries a small risk of disease transmission and is associated with slower biological incorporation.

PRE-OPERATIVE PHASE (Weeks –4 to 0, partially managed remotely with GAF Healthcare coordination):

• Remote consultation: Share MRI, stress X-rays, and clinical history with your assigned GAF Healthcare orthopedic specialist via secure portal. Surgeon confirms operative plan, graft choice, and any concurrent procedures.
• Pre-habilitation (Prehab): 4–6 weeks of targeted quadriceps strengthening, hamstring flexibility, and proprioceptive training to improve pre-operative muscle function and significantly enhance post-operative outcomes. Research demonstrates that prehab reduces post-operative rehabilitation duration by 30–40%.
• Travel planning: GAF Healthcare applies for India e-Medical Visa (processed in 48–72 hours) or UAE entry visa as applicable. Flights and airport transfers are booked.
• Pre-admission (Day –1 to 0): Hospital admission, anesthesia assessment, blood tests, and surgical consent process. Surgeon reviews imaging with patient. Nil by mouth from midnight before surgery.

INTRA-OPERATIVE PHASE (Day 0; Duration: 90–150 minutes depending on technique and concurrent procedures):