Rehabilitative Fate of a Complex Revision Posterior Cruciate Ligament Reconstruction in an Athlete: A Case Report

BACKGROUND: Isolated posterior cruciate ligament (PCL) injuries are rare, with a reported incidence of 1-6%, and sports injuries account for approximately 43% of cases. Failure following primary PCL reconstruction (PCLR) remains challenging, with limited evidence guiding rehabilitation after revision PCLR. The first 12 postoperative weeks are critical for graft protection, osteotomy healing, quadriceps recovery, and weight-bearing progression, particularly in wrestlers who are exposed to high-demand multidirectional knee loading.

CASE PRESENTATION: A 23-year-old international freestyle wrestler with persistent instability following primary PCLR underwent two-stage revision PCLR with internal brace augmentation, lateral extra-articular tenodesis, and corrective tibia-fibular osteotomy.

OUTCOMES: Criterion-based rehabilitation emphasized oedema control, quadriceps activation, range of motion restoration, progressive weight-bearing, gait retraining, and strengthening. At 12 weeks, oedema had resolved, full pain-free knee motion, and independent ambulation were achieved, and knee function improved without complications.

DISCUSSION: This case provides a clinically reproducible framework for early rehabilitation following complex revision PCLR.

LEVEL OF EVIDENCE: 4