Arthroscopic assisted PCL reconstruction: A technical note on potential neurovascular injury related to drill bit configuration

Neurovascular injury is a potential complication during arthroscopic assisted or open posterior cruciate ligament (PCL) reconstruction. The anatomical configuration of the posterior tibia and the square configuration of the end of commonly used drill bits require special attention. One portion of the drill bit may cut out of the tibia < or = 20 mm distal to the exit point of the guide wire. The sharp square edges of these drill bits have a greater potential to traumatize adjacent soft tissue and to increase the risk of neurovascular damage. This risk may be decreased by using a tapered drill bit, an oscillating drill, and careful elevation and retraction of the overlying soft tissue.