Stemcelldoc's Weblog

January 9, 2013

Posterior Cruciate Injection: Accurate Placement

At the Centeno-Schultz Clinic stability is critical as evidenced in our SANS approach: Stability, Articulation, Neurologic and Symmetry.  Joint stability is essential for optimal clinical outcomes.

Accurate needle placement is equally important and is accomplished through direct visualization either by MSK ultrasound or x-ray or both.

The posterior cruciate ligament is large ligament in the knee that provides restraining force to straight posterior translation of the tibia relative to femur.  It originates from  anterolateral aspect of the medial femoral condyle and attached onto the posterior tibia.
VM is a 32 y/o snowboarder seen in clinic today with knee instability and pain.  MRI was significant for partial tearing of the PCL and swelling at its tibial insertion.

Below is an x-ray image of the PCL injection.   A posterior approach was utilized.  The femoral nerve and vasculature was identified by MSK ultrasound.  Thereafter a 25 gauge need was advanced into the PCL at the tibial attachment.  A small amount of contrast was injected with filling of the PCL.Posterior Cruciate Ligament

Patient hopes to return to riding soon and we are expecting snow this weekend.



  1. can you guys treat a, I believe, grade 3 torn (completely torn) pcl? I tore my pcl about 7 years ago (early 2006) playing High School football (im currently 25 years old). I didnt have surgery just Physical training, which I did, to strenghten my quad. but now I would like to get it “fixed” because I am worried about arthritis as I age.

    I would do surgery but I was wondering if stem cell research has advanced to treat completely torn pcl’s as it seems like it can treat completely torn acl’s.

    thank you

    Comment by CrisP — September 2, 2013 @ 6:40 am

    • CrisP,
      Thank you for talking time to read the blog and respond.
      The critical question in your case is wehether or not the PCL sheath is intact. The sheath envelops the PCL and its integreity can be determined by injecting a small amount of contrast into the sheath. If it is intact then stem cells can be injected with the aim of healing the tear.
      A current MRI is required.

      You can upload your study and information onto our website:

      Comment by stemcelldoc — September 3, 2013 @ 5:34 am

      • 1. can an MRI determine if PCL sheath is intact? or do I have to come into one of your facilities (if so, how much is it?)
        2. what is the other options availible if sheath is NOT intact?

        thank you

        Comment by CrisP — September 7, 2013 @ 12:21 am

      • also would insurance cover the check up (ex. initial exam, MRI/ xray (if needed), and the prodecure to get PCL sheath injected w/ small amount of contrast to determine if sheath is intact.

        Comment by CrisP — September 7, 2013 @ 12:24 am

      • Most insurance companies will pay for the initial evaluation, MRI and diagnostic injection to determine the integreity of the ACL shealth.

        Comment by stemcelldoc — September 9, 2013 @ 11:51 am

  2. im scheduled to get an MRI, from my primary physician (Oct 21, 2013). where would I get the diagnostic injection and how much would it cost for that examine? would insurance cover the diagnostic examine?

    thank you

    Comment by CrisP — October 3, 2013 @ 1:30 am

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