Revision Posterior Cruciate Ligament Reconstruction Technique

Background: Revision posterior cruciate ligament reconstruction (PCLR) is challenging, especially in existing semi-anatomic tunnels, whereas there an increased risk of overlapping with a new positioned anatomic tunnel. Few cases were published no consensus regarding the optimal operative technique. Indications: A 22-year-old male patient, failed PCLR hamstring autograft 2020 due to improper tunnels placement, presented for pain and instability his right knee. Physical examination revealed positive drawer reverse Pivot-Shift test, varus-valgus or rotational laxity. Radiograph showed signs arthritis, normal tibial slope, long-leg standing axis. Magnetic resonance imaging rupture PCL graft meniscal, chondral, concomitant injuries. Technique Description: We described single-bundle transtibial technique transeptal portal approach reconstruct PCL. started by preparing allograft internal brace augmentation adjustable button (Arthrex) placed on femoral side cortical fixation. The old semi-anatomical tunnel was drilled grafted using bone dowel (Biobank), inside-out. Under direct visualization via portals, nonanatomic Using shuttle suture, transplant passed fixed at femur two interference screws backup fixation Swive-lock anchor tibia (Arthrex). Results: Favorable functional clinical outcomes improvement anteroposterior stability. Significant improved side-to-side differences stress radiography subjective objective scores. Satisfactory 75% patients returned preinjury Tegner activity scale level function. Discussion/Conclusion: use portals protects vital neurovascular structures ensures proper placement providing attachment. Allograft dowels facilitate revision one-stage procedure filling allowing drill without overlap. strengthens construct protect during revascularization remodeling process facilitating tissue ingrowth incorporation. In surgery, encouraged often essential compromised stock. Patient Consent Disclosure Statement: author(s) attests that consent has been obtained from any patient(s) appearing this publication. If individual may be identifiable, included statement release other written form approval submission