Arthroscopic posterior cruciate ligament repair for acute femoral "peel off" tears.

Posterior cruciate ligament (PCL) injuries can be associated with acute and chronic morbidity. Treatment of PCL disruption is typically either nonoperative or reconstructive, using a graft substitute. We describe a minimally invasive arthroscopic technique for repair of acute PCL tears of the femoral origin. This has been referred to as the femoral "peel off" injury. The procedure makes use of arthroscopic instrumentation to provide a direct repair of the ligament back to the femoral origin. This is a very specific injury often diagnosed with magnetic resonance imaging. This technique is not applicable to interstitial or tibial insertion tears. Operative repair is achieved using accessory portals, and instrumentation to place sutures in the PCL, which are then secured via an accessory incision for fixation. The procedure and clinical experience are discussed in detail, and a case report is included. In this very select and specific type of PCL injury, repair may provide a clinically useful alternative to full PCL reconstruction.