Vishwakarma Nilesh S, Gali Julio Cesar, Gali Julio Cesar Filho, LaPrade Robert F
Mahatma Gandhi Mission Institute of Health Sciences, Department of Orthopedics, MGMIHS, New Mumbai, Maharashtra, India.
Department of Surgery, Faculty of Medical Science and Health, Catholic University of São Paulo, Sorocaba, Brazil.
Arthrosc Tech. 2021 Sep 8;10(10):e2229-e2235. doi: 10.1016/j.eats.2021.05.030. eCollection 2021 Oct.
The posterior cruciate ligament surgery invariably demands adequate posterior compartment visualisation and instrumentation. The addition of posteromedial (PM) portal during posterior cruciate ligament (PCL) surgeries remains essential. The further addition of one more proximal posteromedial (PM) portal further enhances the instrumentation including suture passage in the substance of PCL or screws insertion and more so obviates the need for trans-septal and posterolateral (PL) portals. This additional PM portal is created in the safe zone under direct visualisation utilising outside-in technique and is spaced to prevent crowding of instrument with arthroscope. The proximal higher PM portal serves as instrument portal and provides optimal trajectory for even arthroscopic screw fixation of PCL avulsion fractures.
后交叉韧带手术始终需要对后关节腔进行充分的可视化和器械操作。在后交叉韧带（PCL）手术中增加后内侧（PM）入路仍然至关重要。进一步增加一个更高的近端后内侧（PM）入路可进一步改善器械操作，包括在PCL实质内穿入缝线或拧入螺钉，更重要的是避免了经隔膜和后外侧（PL）入路的需要。这个额外的PM入路是在直视下利用由外向内技术在安全区内创建的，其间隔设置可防止器械与关节镜相互拥挤。更高的近端PM入路用作器械入路，并为PCL撕脱骨折的关节镜螺钉固定提供最佳轨迹。
