Cross-pin femoral fixation in PCL reconstruction: a cadaver study

In PCL reconstruction many techniques have been described. Crucial item in pre-operative planning is graft choice and graft fixation. Compared to other grafts, hamstring is getting more popular because it is longer, has higher mechanical properties and doesn't harm extensor apparatus of the knee. Furthermore the absence of the bone block makes easier hamstring insertion in the femoral tunnel. Hamstring greater disadvantage is fixation. Many fixation devices, used in ACL reconstruction, have been described for PCL procedure. One of these, recently proposed, is a cross-pin femoral fixation technique, for hamstring PCL reconstruction [10]. The authors drilled the femoral tunnel in an inside-out manner [11] (width 8 mm and depth 35 mm) and fixed the hamstring with the Rigidfix (Mitek, Norwood, MA), passing the device via the anterolateral (AL) portal. The aim of this anatomical cadaver study is to evaluate the entrance points of cross-pins and the possible iatrogenic damages, during transverse fixation via anterolateral portal. The device we used is the Rigidfix (Mitek, Norwood, MA), designed to use two biodegradable pins for ACL femoral fixation. Femoral drilling and cross pins insertion were performed on 20 (10x2) fresh frozen cadaver knees. The risk of chondral damage, evaluated during the knees dissection, is high.