Management of posterior cruciate ligament injuries remains a topic of discussion among treating physicians. Injury severity, anatomical location, and presence of concomitant associated knee injuries are important factors that may be used to guide treatment strategies. Various subtypes of posterior cruciate ligament injury have been identified. Each has unique properties that affect treatment design. Among these subtypes is the acute femoral "peel-off" tear, which represents a distinct pattern of injury that consistently has demonstrated a favorable capacity for healing with repair rather than reconstruction. In this article, we present an arthroscopic anatomical repair technique that has been used with success at our institution. It is important to properly identify such injuries in a timely manner so that appropriate treatment is initiated and the patient may be spared a lengthier and more technically complex reconstruction procedure.
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