Salvaging Early EndoButton Migration in PCL Reconstruction: A Case Report Describing a Novel Technical Solution for Femoral Tunnel Complications.

Introduction: Recently, the number of posterior cruciate ligament (PCL) reconstruction surgeries has been increasing. A rare complication of early intratunnel migration of a suspensory cortical button into the femoral tunnel after PCL reconstruction was observed. Case Presentation: A 51-year-old man presented with an isolated PCL rupture and underwent PCL reconstruction surgery. A quadrupled semitendinosus autograft was used; femoral fixation was achieved with a fixed-loop suspensory cortical button (EndoButton; Smith & Nephew), and tibial fixation was achieved with a cortical post technique using a double spike plate (DSP; Smith & Nephew), rather than an interference screw. Seven days after the operation, a radiograph of the knee demonstrated that the EndoButton had migrated into the femoral tunnel. The patient underwent prompt reoperation, and the EndoButton was manually repositioned and augmented by placing a large button onto it to prevent remigration. Conclusions: This case suggests that early postoperative intratunnel migration of a suspensory cortical button after PCL reconstruction can be successfully managed with prompt surgical reduction and augmentation.