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What is the prognosis of a PCL injury in an adolescent who is a competitive swimmer?

Question: What is the prognosis of a PCL injury in an adolescent who is a competitive swimmer?

My daughter is 11 yrs old and a competitive swimmer who has been competing and training at a high level both at Club and Nationals. (5-6 days a week, 2-3 hours a day, so she is dedicated). She has shown great promise and has just begun to "blossom" and started to see the results of all her hard work. That being said.......
She recently (late February) injured her knee as a result of a riding accident, where her knee took the direct impact of the fall. Following initial X-rays and an examination by her doctor, it was determined that there was deep bruising and swelling, but nothing broken etc. She continued to swim for approximately 2-3 weeks, as she was gearing up for a major regional competition. Albeit with limitations as she experienced persistent swelling and pain through out this period. It was thought that her discomfort was a result of a deep bruising and she was managing her injury with frequent icing. Eventually she was referred to an Orthopedic Doctor for further examination and tests. An MRI was done and the diagnosis was a tear in her PCL (inconclusive whether a partial or full tear). Since the MRI, she has been undergoing physio therapy 5 days a week and has continued to swim, however with limited use of her legs as there was still discomfort and pain (especially in the back of her knee). She began to complain more about a "clicking and grinding" in her knee and being unable to perform to the level required, as well as the discomfort being felt, the decision was made to examine her knee more closely with arthroscopic surgery. The reasons that this was considered the best course of action was that the "clicking" sound and grinding may have been a result of some damage to the cartilage that was not picked up on the MRI. The 2 goals were to; 1. Have a look inside to see if this was the case and if so, repair any damage and 2. To get a better look at the PCL (this proved difficult and was inconclusive in determining the extent of the tear - whether partial or complete). The result and diagnosis is; The "clicking" is symptomatic of her PCL tear and all other component parts of the knee are intact and undamaged.
She is now recovering from the surgery and we have had the follow up with her Doctor. It was agreed that we should refer her further and are in the beginning stages of looking for a specialist in Orthopedic Pediatric Injuries / Sports Doctor etc.
We have been told that, as it stands and because she is still growing, the options available are limited to the physiotherapy treatment. Surgery was discussed and it is not an option at this point, primarily because of her age and risk to her growth plates etc. We also have not explored all avenues - IE: discussed with a Specialists in this area. We have been advised that she will be unable to compete at the current competitive level she is at and that medically she should not push it, although she should still swim.
My questions are: Is there hope for her in the immediate future?
What is the consensus regarding an operation to repair the PCL, as there seems to be two polar opinion within the medical community.
What damage (long term) could occur if she continues to swim and train? - IE: Damage to cartilage, Arthritis, etc
Should she stop and if so, how do we deal with the disappointment?!
Please Help!


Hi kikster,

I can't offer anything constructive, but I wanted to empathise - my daughter fully ruptured her Cruciate last August, but we only got the diagnosis two weeks ago (she has struggled on) and we have yet to see a consultant.

She has given up trampoline, cross country and horse riding - the first two she did competitively, and the second for fun.

It really is so frustrating isn't it.