All-Inside Posterior Cruciate Ligament Reconstruction With Remnant Preservation: Anteromedial Portal Technique

The posterior cruciate ligament (PCL) is an important restraint to posterior tibial translation. PCL reconstruction is one of the most challenging procedures, with the literature having described many techniques for reconstruction. Protecting the neurovascular structures, overcoming the "killer turn," preserving bone, and reducing morbidity and postoperative pain are a few of the technical challenges that surgeons often encounter during PCL reconstruction. We describe a technique using a graft-link construct through the anteromedial portal for all-inside PCL reconstruction with remnant preservation that protects the graft from the killer turn of the tibia by smooth passage of the graft over the remnant and improves proprioception, thereby reducing postoperative pain and morbidity and achieving excellent functional outcomes.