Table 2.

Pitfalls and Tips

Pitfalls

When the surgeon is creating the trans-septal portal directly, moving the rod posteriorly while breaking the septum can result in neurovascular injury.

Sometimes, it is a struggle to pass the graft between the remnant PCL bundles and surrounding soft tissues.

The killer-turn effect is still a possibility.

Tips

When creating the trans-septal portal directly, the surgeon should keep the rod anterior and close to the bone as much as possible to prevent posterior neurovascular injury.

Performing sufficient soft-tissue debridement and PCL shrinkage with an electrocautery device is helpful in achieving easier graft passage.

Rasping the acute entrance of the tibial tunnel after reaming is a way to reduce the killer-turn effect.

PCL, posterior cruciate ligament.