Federica Rosso, M. D. , Salvatore Bisicchia, M. D

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Arthroscopic Repair of “Peel-Off” Lesion of the Posterior Cruciate Ligament at the Femoral Condyle Federica Rosso, M.D., Salvatore Bisicchia, M.D., Annunziato Amendola, M.D. Arthroscopy Techniques Volume 3, Issue 1, Pages e149-e154 (February 2014) DOI: 10.1016/j.eats.2013.09.014 Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 1 Sagittal magnetic resonance imaging of right knee: (A) intact ACL and (B) femoral avulsion PCL (arrow). Arthroscopy Techniques 2014 3, e149-e154DOI: (10.1016/j.eats.2013.09.014) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 2 Coronal magnetic resonance imaging of right knee: (a) MCL tibial detachment, (b) minimally depressed lateral tibial plateau fracture, and (c) detachment of medial meniscus from inferior meniscofemoral ligament. Arthroscopy Techniques 2014 3, e149-e154DOI: (10.1016/j.eats.2013.09.014) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 3 Arthroscopic view of right knee. The probe shows some fibers of the PCL still attached to the footprint. Arthroscopy Techniques 2014 3, e149-e154DOI: (10.1016/j.eats.2013.09.014) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 4 Arthroscopic view of right knee. The entire meniscus had risen up off of the tibial side, indicating disruption of the tibial coronary ligament, and the posterior root was probed and appeared to have a stable attachment. Arthroscopy Techniques 2014 3, e149-e154DOI: (10.1016/j.eats.2013.09.014) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 5 Arthroscopic views of right knee. (A) The PCL was detached from its footprint. (B) Evaluation of the ability to ensure PCL reduction to its footprint with the probe. Arthroscopy Techniques 2014 3, e149-e154DOI: (10.1016/j.eats.2013.09.014) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 6 Arthroscopic view of right knee. Using a PowerPick, we performed some microfractures into the footprint to obtain bleeding from the subchondral bone, improving healing of the repaired ligament. Arthroscopy Techniques 2014 3, e149-e154DOI: (10.1016/j.eats.2013.09.014) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 7 With an arthroscopic Scorpion suture passer, 2 No. 2 FiberWire sutures were passed in a figure-of-8 fashion through the posteromedial and anterolateral bundles of the repaired PCL. Arthroscopy Techniques 2014 3, e149-e154DOI: (10.1016/j.eats.2013.09.014) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 8 Arthroscopic view of right knee. Insertion of a 2.9-mm PushLock was performed to ensure PCL reduction to its footprint. Arthroscopy Techniques 2014 3, e149-e154DOI: (10.1016/j.eats.2013.09.014) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

Fig 9 Arthroscopic view of right knee. Final result of PCL repair. The arrows indicate the two 2.9-mm PushLock anchors. Arthroscopy Techniques 2014 3, e149-e154DOI: (10.1016/j.eats.2013.09.014) Copyright © 2014 Arthroscopy Association of North America Terms and Conditions