Technique to facilitate graft passage in posterolateral reconstructions of the knee

This report describes a novel technique to facilitate passage of the transtibial limb of grafts used for reconstruction of the posterolateral corner of the knee. This new method, which places and passes the graft within a 24F (8-mm) chest tube, eliminates the problem of graft impingement at the opening of the posterior tibial tunnel and the need to enlarge the tunnel to achieve graft passage. Enlarging the tunnel is detrimental to obtaining the snug fit that is necessary to maximize incorporation of the graft and minimize postoperative tunnel expansion. This chest tube technique, which has been used in 20 cases to date, makes graft passage expeditious and requires no special instrumentation.