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PCL reconstruction - a stable knee, done properly.

Arthroscopic reconstruction of the posterior cruciate ligament - single- or double-bundle, with your own tendon or a donor graft, and combined ligament work where needed. A consultant knee surgeon, and the honest rehabilitation conversation up front.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What private PCL reconstruction costs in the UK.

Indicative ranges across our partner orthopaedic units.

In short

£9,000–£15,000, home day-case or one night.

Procedure Indicative range
Knee surgery consultation only £250–£450
Arthroscopic PCL reconstruction £9,000–£15,000
PCL reconstruction with allograft £11,000–£17,000
Combined PCL + ACL / multi-ligament £16,000–£28,000
PCL reconstruction with meniscal repair £11,000–£18,000
Revision PCL reconstruction £13,000–£22,000
Post-operative MRI (if needed) £350–£750

Prices vary by hospital, by the surgeon, by graft choice, and by whether other ligaments or the meniscus are addressed at the same time. Multi-ligament and revision cases sit at the top of the range, and rehabilitation is usually costed separately.

The problem

The right call between rehab and surgery, then rehab done properly.

PCL injuries are where over- and under-treatment both happen - operating when good rehab would do, or reconstructing then under-supporting the recovery. We fix both.

  • Not every PCL needs surgery

    Many isolated tears do well with focused physiotherapy. We say so before recommending an operation.

  • Find the combined injuries

    A PCL rarely tears alone in serious trauma. Missing an associated ligament or corner injury is the commonest cause of a poor result.

  • Rehab is the operation’s other half

    A PCL graft needs careful, protected rehabilitation for nine to twelve months. We plan it before you consent, not after.

When it helps

When PCL reconstruction is the right step.

The situations we see most, plus the one red flag that means an emergency assessment rather than a routine appointment.

  • High-grade isolated PCL tear

    A complete tear with marked backward laxity of the shin bone - the situation most likely to benefit from reconstruction, especially in active people.

  • Multi-ligament knee injury

    A PCL torn alongside the ACL, collateral or corner structures - usually from a dashboard injury or serious sports trauma, and reconstructed as part of a bigger repair.

  • Symptomatic instability

    A knee that gives way, feels unstable on stairs or slopes, or aches at the front despite good rehabilitation.

  • PCL avulsion fracture

    The ligament pulled off with a fragment of bone - often best fixed early, and a related but distinct operation to soft-tissue reconstruction.

  • Failed conservative treatment

    Ongoing symptoms after a proper course of physiotherapy, in someone who needs a stable knee for work or sport.

  • Early cartilage or kneecap pain

    Long-standing PCL laxity can overload the kneecap and inner compartment; reconstruction is sometimes offered to protect the joint.

  • High-demand athletes and manual workers

    People whose knee must tolerate pivoting, squatting or heavy lifting, where residual laxity limits performance.

  • Red flag: dislocated knee or absent pulses

    A knee that has dislocated, or a cold, pulseless or numb leg after injury, is an emergency - vascular assessment the same day, not a routine booking.

Graft and technique

Technique and graft both depend on your injury.

What each option involves - single- or double-bundle, transtibial or inlay, and whether the graft is your own tendon or a donor.

  • Single-bundle reconstruction

    The commonest technique - one graft reconstructs the main (anterolateral) bundle of the PCL through bone tunnels. Reliable for most isolated tears.

  • Double-bundle reconstruction

    Two grafts recreate both bundles of the ligament, aiming to restore stability more closely across the range of movement. More complex, chosen selectively.

  • Transtibial technique

    The graft is passed through a tunnel in the tibia around a curve - the traditional, widely used approach.

  • Tibial inlay technique

    The graft is fixed into a trough on the back of the tibia, avoiding the sharp turn of the transtibial tunnel. Used in some revisions and complex cases.

  • Hamstring or quadriceps autograft

    Using your own tendon avoids disease transmission and integrates well, at the cost of a small donor-site effect. A common first choice.

  • Allograft (donor tissue)

    Donor tissue avoids a second wound and suits multi-ligament reconstructions where several grafts are needed. Slightly slower to incorporate.

  • Combined and multi-ligament surgery

    When the ACL, collateral ligaments or posterolateral corner are also injured, they are reconstructed at the same sitting for a stable knee.

  • PCL avulsion fixation

    When the ligament has pulled off with bone, fixing the fragment back - rather than reconstructing the ligament - restores the anatomy directly.

Safety and recovery

What to expect afterwards - honestly.

PCL reconstruction is a well-established operation. The things worth planning are the graft choice, any combined injuries, and - above all - the protected rehabilitation.

  • Anaesthetic and day-case reality

    Most isolated reconstructions are day-case or a single night under general or spinal anaesthetic. Multi-ligament surgery needs a longer stay and a longer recovery.

  • Rehabilitation is the real work

    A PCL graft is protected against gravity pulling the shin backwards, so early rehab is slower and more careful than ACL rehab. The brace-and-physiotherapy plan runs nine to twelve months - commitment here decides the result.

  • Bleeding, infection and clots

    Wound and joint infection are uncommon and usually treatable. DVT prophylaxis and early, guided movement reduce the risk of clots - call the same day for calf pain or breathlessness.

  • Stiffness and kneecap pain

    Some stiffness and front-of-knee discomfort are common early and settle with physiotherapy. Persistent stiffness occasionally needs a manipulation or a minor further procedure.

  • Residual laxity and graft stretch

    PCL grafts can stretch a little over time, so a small amount of residual backward laxity is not unusual. Careful technique and protected rehab minimise it.

  • Nerve and vessel proximity

    The back of the knee holds important nerves and vessels; injury is rare in experienced hands but is the reason multi-ligament and revision work belongs with specialists.

  • Graft-site considerations

    An autograft leaves a small donor effect (hamstring or quadriceps weakness that recovers); an allograft avoids that but incorporates a little more slowly.

  • Return to sport takes patience

    Straight-line jogging often returns around four to six months; pivoting sport usually nine to twelve months, and only when strength and control are tested and passed - not by the calendar alone.

  • Red flags after surgery

    A cold or numb foot, calf pain or swelling, fever with wound discharge, or a knee that becomes hot and very painful need the same-day team or A&E, not a routine call.

Reading your operation note

Your operation note in four parts. Read the last one first.

Whichever graft and technique were used, the note the surgeon sends you keeps to the same shape.

A UK consultant knee surgeon reviewing a patient’s operation notes

A quiet reminder

Surgical language is precise and can read coldly - we translate it for you.

If you would like us to talk you through the operation note and the rehabilitation plan before your review, just ask.

  1. 01 Header

    Injury, graft and technique

    Why the operation was done, the grade of PCL tear, whether other ligaments were involved, and the graft and technique used.

  2. 02 Technique

    Findings inside the joint

    The state of the cartilage and menisci, tunnel positions, fixation used, and any repairs done at the same time.

  3. 03 Findings

    Stability achieved

    How the knee tested at the end of surgery, and any tissue or fragment noted or fixed.

  4. 04 Impression

    Rehab plan and milestones

    Read this first: the brace regime, weight-bearing rules, physiotherapy stages and the timeline back to work and sport.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

PCL reconstruction is usually covered when medically indicated after injury, subject to pre-authorisation; post-operative physiotherapy allowances vary by policy.

Frequently asked

Everything we get asked about PCL reconstruction.

Quick answers on whether you need surgery, graft choice, recovery, cost and return to sport.

  • What is PCL reconstruction?

    PCL reconstruction is keyhole (arthroscopic) knee surgery that replaces a torn posterior cruciate ligament - the ligament deep in the knee that stops the shin bone sliding backwards. A tendon graft, taken from your own knee or from a donor, is passed through bone tunnels and fixed to recreate the ligament. It is used mainly for high-grade tears, symptomatic instability and multi-ligament injuries.

  • Do all PCL tears need surgery?

    No. Many isolated PCL injuries, especially lower-grade ones, do very well with a focused physiotherapy programme that strengthens the quadriceps to compensate. Surgery is usually reserved for high-grade tears, knees that remain unstable despite good rehabilitation, PCL injuries combined with other torn ligaments, and avulsion fractures. We are honest about when rehab alone is the better route.

  • Which graft is best - my own tendon or a donor?

    Both work well and the choice is individual. An autograft (your own hamstring or quadriceps tendon) avoids any risk of disease transmission and integrates reliably, at the cost of a small donor-site effect. An allograft (donor tissue) avoids a second wound and suits multi-ligament reconstructions needing several grafts, but incorporates a little more slowly. Your surgeon matches the graft to your injury and goals.

  • How long is recovery and when can I return to sport?

    PCL rehabilitation is deliberately careful because the graft has to be protected from the shin drifting backwards. Expect a brace and crutches early on, straight-line jogging around four to six months, and a return to pivoting sport at roughly nine to twelve months - and only once strength and control tests are passed, not by time alone.

  • How much does private PCL reconstruction cost in the UK?

    Roughly £9,000–£15,000 for an arthroscopic reconstruction with your own tendon, £11,000–£17,000 with an allograft, and £16,000–£28,000 for combined or multi-ligament surgery. Revision reconstruction is typically £13,000–£22,000.

  • What happens if I leave a PCL injury untreated?

    Some people manage well long-term with strong quadriceps and no instability. Others develop recurrent giving-way, front-of-knee and inner-compartment pain, and - over years - an increased risk of cartilage wear. A proper assessment weighs your grade of injury, your symptoms and your activity demands before deciding between rehabilitation and reconstruction.

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