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the arthroscopic inlay posterior cruciate ligament reconstruction with the PCL tightrope is a technique used to allow minimally invasive reconstruction of a torn posterior cruciate ligament if the posterior cruciate ligament is not repaired meniscal tears and arthritis may occur in the knee the surgeon begins by flexing the knee and introducing a guide through a small incision on the front of the knee the guide is placed in the original area where the PCL attaches on the lower leg bone a special pin called a flip cutter is drilled through the bone and into the joint part of the drill guide is tapped into place with a mallet to facilitate drilling by pushing a button on the flip cutter the tip is rotated into a cutting position the flip cutter is then drilled back into the bone to create a socket where the graft will eventually be placed the flip cutter is removed and the suture is passed into the joint and out of the skin for later graft passing the tendon graft is prepared to match t