Single-Bundle Posterior Cruciate Ligament Reconstruction Using Autologous Hamstrings With Mesh and Suture Tape Augmentation With Transtibial Tubercle Fixation

The posterior cruciate ligament (PCL) is the largest and strongest ligament of the knee, primarily functioning to restrict posterior tibial translation and serving as the main posterior stabilizer. However, posterior cruciate ligament reconstruction (PCLR) frequently is complicated by residual laxity and relatively high failure rates. Mesh has been widely used in clinical practice, and suture tape augmentation in PCLR has demonstrated favorable clinical outcomes. In addition, the combined transtibial tuberosity fixation significantly enhances fixation strength. In this Technical Note, we describe a PCLR technique incorporating mesh augmentation, suture augmentation, and the combined transtibial tuberosity fixation. This technique may reduce graft degeneration resulting from the "killer turn" and improve posterior knee stability.