Remnant-Preserving Posterior Cruciate Ligament Reconstruction: Arthroscopic Transseptal, Rod and Pulley Technique Bancha Chernchujit, M.D., Supawat Samart,

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Remnant-Preserving Posterior Cruciate Ligament Reconstruction: Arthroscopic Transseptal, Rod and Pulley Technique Bancha Chernchujit, M.D., Supawat Samart, M.D., Pongtep Na Nakorn, M.D. Arthroscopy Techniques Volume 6, Issue 1, Pages e15-e20 (February 2017) DOI: 10.1016/j.eats.2016.08.031 Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 1 From the anteromedial viewing portal; remnant of posterior cruciate ligament (*) was left intact. Arthroscopy Techniques 2017 6, e15-e20DOI: (10.1016/j.eats.2016.08.031) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 2 Translumination from light source could be clearly seen from outside (white arrow). Then the needle was used as guidance for posteromedial portal creation. From an anterolateral portal view (left picture), the needle end was visible (*). Arthroscopy Techniques 2017 6, e15-e20DOI: (10.1016/j.eats.2016.08.031) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 3 Both posteromedial and posterolateral portals (white arrows) were very useful for viewing and working in the posterior compartment. Arthroscopy Techniques 2017 6, e15-e20DOI: (10.1016/j.eats.2016.08.031) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 4 From a posterolateral viewing portal and instrument inserted from the posteromedial portal, the tibial insertion of posterior cruciate ligament was clearly seen (*). The tibial tunnel was accurately anatomically created (white arrow). Arthroscopy Techniques 2017 6, e15-e20DOI: (10.1016/j.eats.2016.08.031) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 5 From the anteromedial viewing portal and instrument inserted from the anterolateral portal, a femoral tunnel was created at the posterior cruciate ligament remnant footprint (white arrow). Arthroscopy Techniques 2017 6, e15-e20DOI: (10.1016/j.eats.2016.08.031) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 6 From the anteromedial viewing portal, while passing the posterior cruciate ligament graft (*) from the tibial tunnel to the anterior compartment, a Wissinger rod (#) was used as a pulley to prevent graft damage from “killer turn.” Arthroscopy Techniques 2017 6, e15-e20DOI: (10.1016/j.eats.2016.08.031) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 7 The posterior cruciate ligament graft (*) was passed over the remnant (#) into the femoral tunnel. Arthroscopy Techniques 2017 6, e15-e20DOI: (10.1016/j.eats.2016.08.031) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 8 Posterior cruciate ligament reconstruction with remnant augmentation was anatomic and there was no impingement (white arrows). The left picture was from the anterolateral viewing portal. Right picture was from the posterolateral viewing portal. Arthroscopy Techniques 2017 6, e15-e20DOI: (10.1016/j.eats.2016.08.031) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 9 Radiographs before and after posterior cruciate ligament reconstruction show anatomic tunnels (white arrows). Arthroscopy Techniques 2017 6, e15-e20DOI: (10.1016/j.eats.2016.08.031) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions