# Ultrasound-Assisted Anatomic Posterior Cruciate Ligament Reconstruction With Remnant Preservation by Reference to Distal Reflection of the Posterior Capsule and Posterior Septum

## TL;DR

This paper introduces a new ultrasound-assisted technique for PCL reconstruction that improves success rates by preserving anatomical structures and minimizing graft complications.

## Contribution

The novel contribution is an ultrasound-assisted PCL reconstruction method that uses distal posterior capsule reflection and posterior septum as references for tibial tunnel placement.

## Key findings

- The technique preserves the posterior septum and minimizes the impact of the 'killer turn' on graft success.
- Using ultrasound assistance improves the accuracy of tibial tunnel placement in PCL reconstruction.
- The method effectively enhances the success rate of PCL reconstruction surgeries.

## Abstract

Compared with anterior cruciate ligament reconstruction, posterior cruciate ligament (PCL) reconstruction has a higher failure rate and revision rate, which is associated with multiple factors such as graft option, fixation method, postoperative rehabilitation, and management of concomitant injuries. Among them, “killer turn” is a key factor in the failure of PCL reconstruction. Although there are various techniques for PCL reconstruction, the ideal surgery remains controversial. Combined with our clinical experience, ultrasound-assisted positioning is used to locate the tibial tunnel with the distal posterior capsule reflection and the posterior septum as reference to safely achieve anatomic remnant preservation and PCL reconstruction. This technique not only preserves the integrity of the posterior septum but also minimizes the impact of the “killer turn” on the graft by keeping the tibial tract as low as possible and effectively improves the success rate of PCL reconstruction.