Abstract
Compared with anterior cruciate ligament reconstruction, posterior cruciate ligament (PCL) reconstruction has a higher failure rate and revision rate, which is associated with multiple factors such as graft option, fixation method, postoperative rehabilitation, and management of concomitant injuries. Among them, "killer turn" is a key factor in the failure of PCL reconstruction. Although there are various techniques for PCL reconstruction, the ideal surgery remains controversial. Combined with our clinical experience, ultrasound-assisted positioning is used to locate the tibial tunnel with the distal posterior capsule reflection and the posterior septum as reference to safely achieve anatomic remnant preservation and PCL reconstruction. This technique not only preserves the integrity of the posterior septum but also minimizes the impact of the "killer turn" on the graft by keeping the tibial tract as low as possible and effectively improves the success rate of PCL reconstruction.