Minimally Invasive Approach Using 2 Posteromedial Portals for Preserving Ligament Integrity in Arthroscopic Pull-Out Technique for Posterior Cruciate Ligament Tibial Avulsion Fractures.

Posterior cruciate ligament (PCL) tibial avulsion fractures, although rare, can lead to significant complications, such as nonunion, restricted range of motion, and knee instability, if not treated effectively. This report presents an arthroscopic pull-out technique using 2 posteromedial portals, allowing exclusive execution of the pull-out procedure from these portals. This approach minimizes damage to the anterior cruciate ligament and PCL, which are often compromised by traditional methods that use anterior portals requiring dissection between these ligaments. By avoiding disruption of the ligamentous anatomy, this technique not only enhances surgical safety but also optimizes the potential for achieving appropriate tensioning during repair. This article aimed to demonstrate the benefits of this technique in reducing PCL avulsion fractures while preserving ligament integrity and minimizing invasive measures.