Broken Beath Pin Tip During Arthroscopic PCL Reconstruction: A Rare Complication

Instrument breakage during arthroscopic procedures is rare but can pose notable challenges. We present a case of Beath pin breakage during posterior cruciate ligament (PCL) tunnel preparation, requiring a separate incision for retrieval. A 38-year-old man with a multiligamentous right knee injury (Schenck KDIIIL) and common peroneal nerve palsy underwent arthroscopic anterior cruciate ligament (ACL) and PCL reconstruction with lateral collateral ligament (LCL) reconstruction. During PCL tibial tunnel preparation, the Beath pin tip broke and could not be retrieved arthroscopically. Fluoroscopic imaging confirmed the fragment's extracapsular location posterior to the tibial plateau. The patient was counseled, and a second procedure was done through an open posterior approach under fluoroscopic guidance. The fragment was successfully removed, and the patient had an uneventful recovery. At 6-week follow-up, he had full knee range of motion and improved ankle dorsiflexion. This case highlights an uncommon complication of PCL reconstruction, emphasizing the importance of intraoperative vigilance, careful trajectory assessment, and appropriate retrieval strategies.