Graft tunnel positioning during PCL reconstruction

This chapter will review the scientific and surgical literature relating to PCL reconstruction, which is a subject that has received relatively little attention and that remains a subject for debate. In order for a PCL reconstruction to be classed as “successful” objectively, it has to reduce the pathological posterior translation laxity at least close to ‘normal’. Because of variability between people, normal is usually defi ned as being a match to the laxity measured on the contralateral knee, with the proviso that the other knee should itself not have a history of injury that could have aff ected its anterior-posterior (AP) translation laxity (1). Methods for objective measurement of tibial resting position and laxity with respect to the femur are beyond the scope of this chapter, but the reader should note the probability that PCL damage will aff ect the neutral resting position of the tibia, which usually drops posteriorly.