Arthroscopic PCL Reconstruction

Arthroscopic PCL reconstruction is a keyhole surgical procedure that uses small incisions and a camera-assisted system (arthroscope) to rebuild the torn ligament. A graft, either from the patient (autograft) or a donor (allograft), is positioned in the anatomical location of the original ligament and fixed securely with screws or anchors. The goal is to restore normal knee biomechanics with less tissue disruption than open surgery.

This procedure is typically recommended when:

• The PCL is completely torn, leading to significant instability.
• Conservative treatments (bracing, physiotherapy, medications) have failed.
• The patient experiences repeated episodes of the knee “giving way.”
• Athletes or active individuals want to return to high-demand physical activity.
• Associated injuries (meniscus, cartilage, or multiple ligaments) require simultaneous repair.

1. Preoperative Evaluation
   Imaging such as MRI  confirms the severity of the tear and guides surgical planning.
2. Arthroscopic Access
   Small incisions are made, and an arthroscope is inserted to visualize the knee joint in detail. Specialized instruments are used through other small portals.
3. Graft Harvesting and Preparation
   • Autograft: Tissue taken from the patient’s hamstring, patellar tendon, or quadriceps tendon.
   • Allograft: Donor tissue prepared for surgical use.
     The graft is trimmed and shaped to match the anatomical PCL.
4. Graft Placement and Fixation
   Tunnels are drilled in the femur and tibia at the exact locations of the natural PCL attachment points. The graft is threaded through these tunnels and secured with screws or fixation devices, ensuring proper tension and alignment.
5. Closure
   Once stability is confirmed, the small incisions are closed, and the knee is bandaged. A brace is applied for protection during the early recovery phase.

Recovery is gradual and requires a structured physiotherapy program:

• Early Phase (Weeks 0–6): Swelling control, pain management, and gentle range-of-motion exercises.
• Intermediate Phase (Weeks 6–12): Progressive strengthening of the quadriceps, hamstrings, and hip muscles, along with balance training.
• Advanced Phase (Months 3–6): Sport-specific drills, agility exercises, and functional strengthening.
• Return to Sports (6–9+ months): Full clearance is given once stability and strength are restored.

• Minimally invasive with smaller incisions and faster recovery.
• Restores knee stability and function.
• Reduces risk of further injury to cartilage or meniscus.
• Prevents long-term complications such as early arthritis.
• Enables return to daily life, work, and sports with confidence.

While generally safe, risks include infection, stiffness, graft failure, or blood clots. Success depends on surgical expertise, the quality of the graft, and strict adherence to the rehabilitation plan.

Arthroscopic PCL reconstruction is a modern, minimally invasive technique that restores stability and function in patients with severe PCL injuries. With precise surgical repair and a tailored rehabilitation program, most patients can return to active lifestyles while protecting their knees from future complications.