The purpose of this article is to present the incidence of posterior cruciate ligament (PCL) injuries in trauma patients with acute hemarthrosis of the knee. There were 222 acute knee injuries with hemarthrosis presented to our regional trauma center over a 38-month period. PCL injuries occurred in 38% (85 of 222) acute knee injuries; 56.5% (48 of 85) were trauma patients, and 32.9% (28 of 85) were sports related. Higher energy mechanisms may account for the difference. Isolated PCL injuries were rare (3.5%, 3 of 85), whereas 96.5% (82 of 85) of PCL injuries occurred in combination with other ligament injuries. Trauma patients have a higher incidence of PCL injuries than do athletes. Acute knee hemarthrosis in trauma patients should elevate suspicion for multiple knee ligament injuries involving the posterior cruciate ligament.
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