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![Page 1: Double-Bundle Posterior Cruciate Ligament Reconstruction Technique with Use of Endoscopic Femoral Graft Placement by Robert F. LaPrade, and Casey M. Pierce.](https://reader035.fdocuments.in/reader035/viewer/2022081515/56649e4d5503460f94b4385c/html5/thumbnails/1.jpg)
Double-Bundle Posterior Cruciate Ligament Reconstruction Technique with Use of Endoscopic
Femoral Graft Placement
by Robert F. LaPrade, and Casey M. Pierce
JBJS Essent Surg TechVolume 2(1):e1
January 11, 2012
©2012 by The Journal of Bone and Joint Surgery, Inc.
![Page 2: Double-Bundle Posterior Cruciate Ligament Reconstruction Technique with Use of Endoscopic Femoral Graft Placement by Robert F. LaPrade, and Casey M. Pierce.](https://reader035.fdocuments.in/reader035/viewer/2022081515/56649e4d5503460f94b4385c/html5/thumbnails/2.jpg)
Robert F. LaPrade, and Casey M. Pierce JBJS Essent Surg Tech 2012;2:e1
©2012 by The Journal of Bone and Joint Surgery, Inc.
![Page 3: Double-Bundle Posterior Cruciate Ligament Reconstruction Technique with Use of Endoscopic Femoral Graft Placement by Robert F. LaPrade, and Casey M. Pierce.](https://reader035.fdocuments.in/reader035/viewer/2022081515/56649e4d5503460f94b4385c/html5/thumbnails/3.jpg)
Robert F. LaPrade, and Casey M. Pierce JBJS Essent Surg Tech 2012;2:e1
©2012 by The Journal of Bone and Joint Surgery, Inc.
![Page 4: Double-Bundle Posterior Cruciate Ligament Reconstruction Technique with Use of Endoscopic Femoral Graft Placement by Robert F. LaPrade, and Casey M. Pierce.](https://reader035.fdocuments.in/reader035/viewer/2022081515/56649e4d5503460f94b4385c/html5/thumbnails/4.jpg)
Robert F. LaPrade, and Casey M. Pierce JBJS Essent Surg Tech 2012;2:e1
©2012 by The Journal of Bone and Joint Surgery, Inc.
![Page 5: Double-Bundle Posterior Cruciate Ligament Reconstruction Technique with Use of Endoscopic Femoral Graft Placement by Robert F. LaPrade, and Casey M. Pierce.](https://reader035.fdocuments.in/reader035/viewer/2022081515/56649e4d5503460f94b4385c/html5/thumbnails/5.jpg)
Robert F. LaPrade, and Casey M. Pierce JBJS Essent Surg Tech 2012;2:e1
©2012 by The Journal of Bone and Joint Surgery, Inc.
![Page 6: Double-Bundle Posterior Cruciate Ligament Reconstruction Technique with Use of Endoscopic Femoral Graft Placement by Robert F. LaPrade, and Casey M. Pierce.](https://reader035.fdocuments.in/reader035/viewer/2022081515/56649e4d5503460f94b4385c/html5/thumbnails/6.jpg)
Robert F. LaPrade, and Casey M. Pierce JBJS Essent Surg Tech 2012;2:e1
©2012 by The Journal of Bone and Joint Surgery, Inc.
![Page 7: Double-Bundle Posterior Cruciate Ligament Reconstruction Technique with Use of Endoscopic Femoral Graft Placement by Robert F. LaPrade, and Casey M. Pierce.](https://reader035.fdocuments.in/reader035/viewer/2022081515/56649e4d5503460f94b4385c/html5/thumbnails/7.jpg)
Robert F. LaPrade, and Casey M. Pierce JBJS Essent Surg Tech 2012;2:e1
©2012 by The Journal of Bone and Joint Surgery, Inc.
![Page 8: Double-Bundle Posterior Cruciate Ligament Reconstruction Technique with Use of Endoscopic Femoral Graft Placement by Robert F. LaPrade, and Casey M. Pierce.](https://reader035.fdocuments.in/reader035/viewer/2022081515/56649e4d5503460f94b4385c/html5/thumbnails/8.jpg)
Robert F. LaPrade, and Casey M. Pierce JBJS Essent Surg Tech 2012;2:e1
©2012 by The Journal of Bone and Joint Surgery, Inc.
![Page 9: Double-Bundle Posterior Cruciate Ligament Reconstruction Technique with Use of Endoscopic Femoral Graft Placement by Robert F. LaPrade, and Casey M. Pierce.](https://reader035.fdocuments.in/reader035/viewer/2022081515/56649e4d5503460f94b4385c/html5/thumbnails/9.jpg)
Robert F. LaPrade, and Casey M. Pierce JBJS Essent Surg Tech 2012;2:e1
©2012 by The Journal of Bone and Joint Surgery, Inc.
![Page 10: Double-Bundle Posterior Cruciate Ligament Reconstruction Technique with Use of Endoscopic Femoral Graft Placement by Robert F. LaPrade, and Casey M. Pierce.](https://reader035.fdocuments.in/reader035/viewer/2022081515/56649e4d5503460f94b4385c/html5/thumbnails/10.jpg)
Robert F. LaPrade, and Casey M. Pierce JBJS Essent Surg Tech 2012;2:e1
©2012 by The Journal of Bone and Joint Surgery, Inc.
![Page 11: Double-Bundle Posterior Cruciate Ligament Reconstruction Technique with Use of Endoscopic Femoral Graft Placement by Robert F. LaPrade, and Casey M. Pierce.](https://reader035.fdocuments.in/reader035/viewer/2022081515/56649e4d5503460f94b4385c/html5/thumbnails/11.jpg)
Robert F. LaPrade, and Casey M. Pierce JBJS Essent Surg Tech 2012;2:e1
©2012 by The Journal of Bone and Joint Surgery, Inc.
![Page 12: Double-Bundle Posterior Cruciate Ligament Reconstruction Technique with Use of Endoscopic Femoral Graft Placement by Robert F. LaPrade, and Casey M. Pierce.](https://reader035.fdocuments.in/reader035/viewer/2022081515/56649e4d5503460f94b4385c/html5/thumbnails/12.jpg)
Arthroscopic image showing the “slack” ACL (yellow arrow) due to the loss of support from the torn PCL.
Robert F. LaPrade, and Casey M. Pierce JBJS Essent Surg Tech 2012;2:e1
©2012 by The Journal of Bone and Joint Surgery, Inc.
![Page 13: Double-Bundle Posterior Cruciate Ligament Reconstruction Technique with Use of Endoscopic Femoral Graft Placement by Robert F. LaPrade, and Casey M. Pierce.](https://reader035.fdocuments.in/reader035/viewer/2022081515/56649e4d5503460f94b4385c/html5/thumbnails/13.jpg)
Arthroscopic image showing a coagulator marking the PCL bundle attachment sites on the femur.
Robert F. LaPrade, and Casey M. Pierce JBJS Essent Surg Tech 2012;2:e1
©2012 by The Journal of Bone and Joint Surgery, Inc.
![Page 14: Double-Bundle Posterior Cruciate Ligament Reconstruction Technique with Use of Endoscopic Femoral Graft Placement by Robert F. LaPrade, and Casey M. Pierce.](https://reader035.fdocuments.in/reader035/viewer/2022081515/56649e4d5503460f94b4385c/html5/thumbnails/14.jpg)
Arthroscopic image showing the “shiny white fibers” of the posterior horn of the medial meniscus (yellow arrow).
Robert F. LaPrade, and Casey M. Pierce JBJS Essent Surg Tech 2012;2:e1
©2012 by The Journal of Bone and Joint Surgery, Inc.
![Page 15: Double-Bundle Posterior Cruciate Ligament Reconstruction Technique with Use of Endoscopic Femoral Graft Placement by Robert F. LaPrade, and Casey M. Pierce.](https://reader035.fdocuments.in/reader035/viewer/2022081515/56649e4d5503460f94b4385c/html5/thumbnails/15.jpg)
Intraoperative photograph showing proper placement of the tibial guide prior to drilling of the guidepin.
Robert F. LaPrade, and Casey M. Pierce JBJS Essent Surg Tech 2012;2:e1
©2012 by The Journal of Bone and Joint Surgery, Inc.
![Page 16: Double-Bundle Posterior Cruciate Ligament Reconstruction Technique with Use of Endoscopic Femoral Graft Placement by Robert F. LaPrade, and Casey M. Pierce.](https://reader035.fdocuments.in/reader035/viewer/2022081515/56649e4d5503460f94b4385c/html5/thumbnails/16.jpg)
Fig. 5-A Intraoperative photograph showing proper placement of the tibial guidepin at approximately a 45° angle to the tibial shaft or diaphysis.
Robert F. LaPrade, and Casey M. Pierce JBJS Essent Surg Tech 2012;2:e1
©2012 by The Journal of Bone and Joint Surgery, Inc.
![Page 17: Double-Bundle Posterior Cruciate Ligament Reconstruction Technique with Use of Endoscopic Femoral Graft Placement by Robert F. LaPrade, and Casey M. Pierce.](https://reader035.fdocuments.in/reader035/viewer/2022081515/56649e4d5503460f94b4385c/html5/thumbnails/17.jpg)
Intraoperative anteroposterior fluoroscopic view (Fig. 6-A) and lateral fluoroscopic view (Fig. 6-B) demonstrating the proper position for the tibial tunnel guidepin and the “champagne-glass drop-
off” (yellow line).
Robert F. LaPrade, and Casey M. Pierce JBJS Essent Surg Tech 2012;2:e1
©2012 by The Journal of Bone and Joint Surgery, Inc.
![Page 18: Double-Bundle Posterior Cruciate Ligament Reconstruction Technique with Use of Endoscopic Femoral Graft Placement by Robert F. LaPrade, and Casey M. Pierce.](https://reader035.fdocuments.in/reader035/viewer/2022081515/56649e4d5503460f94b4385c/html5/thumbnails/18.jpg)
Arthroscopic image showing the proper location of the femoral tunnels viewed through the anterolateral portal.
Robert F. LaPrade, and Casey M. Pierce JBJS Essent Surg Tech 2012;2:e1
©2012 by The Journal of Bone and Joint Surgery, Inc.
![Page 19: Double-Bundle Posterior Cruciate Ligament Reconstruction Technique with Use of Endoscopic Femoral Graft Placement by Robert F. LaPrade, and Casey M. Pierce.](https://reader035.fdocuments.in/reader035/viewer/2022081515/56649e4d5503460f94b4385c/html5/thumbnails/19.jpg)
Intraoperative photograph showing the femoral bundle grafts.
Robert F. LaPrade, and Casey M. Pierce JBJS Essent Surg Tech 2012;2:e1
©2012 by The Journal of Bone and Joint Surgery, Inc.
![Page 20: Double-Bundle Posterior Cruciate Ligament Reconstruction Technique with Use of Endoscopic Femoral Graft Placement by Robert F. LaPrade, and Casey M. Pierce.](https://reader035.fdocuments.in/reader035/viewer/2022081515/56649e4d5503460f94b4385c/html5/thumbnails/20.jpg)
Intraoperative photographs showing the PCL reconstruction grafts before they are passed through the tibial tunnel (Fig. 9-A) and the proper position after they are passed through the tibial
tunnel (Fig. 9-B).
Robert F. LaPrade, and Casey M. Pierce JBJS Essent Surg Tech 2012;2:e1
©2012 by The Journal of Bone and Joint Surgery, Inc.
![Page 21: Double-Bundle Posterior Cruciate Ligament Reconstruction Technique with Use of Endoscopic Femoral Graft Placement by Robert F. LaPrade, and Casey M. Pierce.](https://reader035.fdocuments.in/reader035/viewer/2022081515/56649e4d5503460f94b4385c/html5/thumbnails/21.jpg)
Intraoperative photographs showing fixation of the reconstruction bundle grafts to the tibia with use of surgical staples.
Robert F. LaPrade, and Casey M. Pierce JBJS Essent Surg Tech 2012;2:e1
©2012 by The Journal of Bone and Joint Surgery, Inc.