Arthroscopic PCL Avulsion Fixation

Arthroscopic PCL avulsion fixation is a minimally invasive surgical technique performed through small incisions using an arthroscope (a camera-assisted surgical tool). The goal is to reattach the avulsed ligament fragment to its original site on the tibia using specialized fixation devices such as screws, sutures, or anchors. By doing so, the natural anatomy of the knee is preserved and stability is restored.

Surgery is recommended when:

• The PCL has been completely avulsed from its tibial attachment.
• The knee remains unstable despite conservative treatment (bracing, physiotherapy).
• The patient is young, athletic, or requires high knee function for daily activities.
• Associated injuries (e.g., meniscus or cartilage damage) need simultaneous repair.

1. Anesthesia
   The patient is given general or regional anesthesia for comfort and pain control.
2. Arthroscopic Access
   Small keyhole incisions are made around the knee. An arthroscope provides a clear, magnified view of the joint on a monitor.
3. Assessment and Preparation
   The surgeon identifies the avulsed PCL fragment and cleans the defect area to prepare for fixation.
4. Reattachment of the PCL
   The avulsed ligament and bone fragment are carefully repositioned. Specialized fixation devices—such as screws or  suture anchors—are used to secure the PCL back onto the tibia.
5. Final Check and Closure
   The surgeon ensures that the ligament is stable and that knee motion is smooth before closing the tiny incisions with sutures or steri-strips.

Rehabilitation is crucial for a successful outcome after arthroscopic PCL avulsion fixation:

• Initial Protection: A knee brace and crutches are used for several weeks to protect the repair.
• Controlled Weight-Bearing: Patients gradually progress from partial to full weight-bearing under physiotherapist guidance.
• Structured Physiotherapy: Exercises restore flexibility, strengthen the quadriceps and hamstrings, and improve balance.
• Return to Sports: Low-impact activities typically begin around 3–4 months, with full return to pivoting sports usually after 6–9 months.

• Minimally invasive: Smaller incisions, less tissue damage, and faster recovery.
• Restores knee stability: Allows patients to regain mobility and confidence.
• Prevents long-term damage: Reduces risk of cartilage wear, meniscus tears, and early arthritis.
• Better outcomes for active individuals: Enables return to high-demand activities and sports.

Although generally safe, potential risks include infection, blood clots, stiffness, hardware irritation, or incomplete healing. Outcomes are strongly influenced by surgical expertise, rehabilitation compliance, and the extent of associated injuries.

Arthroscopic PCL avulsion fixation is a highly effective, minimally invasive procedure that restores knee stability and function after a PCL injury. With precise surgical repair and a structured rehabilitation program, most patients can return to active lifestyles while protecting their knees from long-term complications.