All-Anterior Approach for Arthroscopic Posterior Cruciate Ligament Reconstruction With Remnant Preservation

We describe the all-anterior approach for arthroscopic posterior cruciate ligament (PCL) reconstruction with remnant preservation. In this technique, PCL is reconstructed through 3 anterior portals: anterolateral portal, anteromedial portal, and inferior anterolateral portal, whereas the PCL remnant is preserved with great possibility. With the PCL elevator and wire catcher (Smith & Nephew), a self-made wire loop is introduced into the joint through the tibial tunnel, and is used to pass the graft in an all-inside-out fashion. In the transtibial PCL reconstruction technique, posterior portals are routinely adopted and the PCL remnant is often removed for good vision and adequate operative space, which can prolong surgery time and increase the potential risk of iatrogenic injury. In comparison, this technique not only simplifies the surgical procedure and reduces surgical trauma, but also preserves the remnant for our patients.