Multiple Looping Technique for Tibial Fixation in Posterior Cruciate Ligament Reconstruction of the Knee Jung Ho Noh, M.D., Ph.D., Kyoung Ho Yoon, M.D.,

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Multiple Looping Technique for Tibial Fixation in Posterior Cruciate Ligament Reconstruction of the Knee Jung Ho Noh, M.D., Ph.D., Kyoung Ho Yoon, M.D., Ph.D., Sang Jun Song, M.D., Ph.D., Young Hak Roh, M.D., Jae Woo Lee, M.D. Arthroscopy Techniques Volume 4, Issue 1, Pages e13-e17 (February 2015) DOI: 10.1016/j.eats.2014.09.011 Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 1 The graft is folded into 2 strands and is trimmed to fit the 10-mm tunnel. The graft is looped over the oval-shaped Ligament Washer. The length of the graft is set at 11 to 11.5 cm. Arthroscopy Techniques 2015 4, e13-e17DOI: (10.1016/j.eats.2014.09.011) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 2 Creation of multiple loops using the Ligament Washer, which is supposed to be in the tibial tunnel, versus the 17-mm Suture Washer, which is supposed to be at the anterior aperture of the tibial tunnel, after insertion of the tibial end of the graft into the tunnel. (A) Each string of the No. 2 Ethibond sling suture (green) is inserted into each hole of the 17-mm Suture Washer. (B) Both ends of the sling suture of No. 2 Ethibond and 1 end of No. 2 FiberWire (white) are tied together. Then, a closed loop of No. 2 Ethibond, which is tethered with No. 2 FiberWire, becomes looped over both the Ligament Washer and the 17-mm Suture Washer. (C) After the closed loop of No. 2 Ethibond is revolved 5 times around the Ligament Washer and 17-mm Suture Washer in one direction and the No. 2 Ethibond is removed, 5-time winding loops of No. 2 FiberWire are created. (D) After both ends of the suture are pulled gently to make the tension of each loop evenly distributed, they are tied together. Arthroscopy Techniques 2015 4, e13-e17DOI: (10.1016/j.eats.2014.09.011) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

Fig 3 Postoperative anteroposterior and lateral radiographs of knee. Arthroscopy Techniques 2015 4, e13-e17DOI: (10.1016/j.eats.2014.09.011) Copyright © 2015 Arthroscopy Association of North America Terms and Conditions