Arthroscopic suture fixation for bony avulsion of the posterior cruciate ligament

We describe a new arthroscopic technique for suture fixation of a posterior cruciate ligament (PCL) avulsion fracture from the tibia. This technique i s indicated when the size of the avulsed fragment is small and fixation wit h a screw or pins is inadequate. Three portals are used: a parapatellar ant eromedial portal, a high posteromedial portal, and a posterolateral portal. Using a PCL tibial guide, 2 bone tunnels are made from the anterior cortex of the tibia to the medial and lateral border of the avulsed site. One or 2 strands of 23-gauge wire or multiple nonabsorbable sutures are used for f ixation through the tunnels. If the bony fragment is small or comminuted, f ixation with wires or sutures leads to rigid fixation and early rehabilitat ion.