To restore the posterior stability of the knee after atibial posterior cruciate ligament (PCL) avulsion with asuture-button construct. Acute solid and monofragment bony avulsion of the tibial PCL insertion. Chronic condition of avulsion fractures or posterior instability, multifragment avulsions, thin bone pieces, advanced knee osteoarthritis, high-grade soft tissue injury, infection. Supine position, all-arthroscopic treatment via posteromedial and posterolateral portal, arthroscopic visualization and fracture reduction, transtibial drilling with acannulated 2.4 mm drill, reduction of the fragment via FiberTape™ and Dog Bone. Knotting of the tapes against an additional Dog Bone at the anterior aspect of the tibia. Intraoperative x‑ray. Knee extension brace with posterior tibial support for 6weeks, 20 kg partial weight-bearing and restricted flexion up to 90° for 6weeks, physiotherapy in prone position from the first postoperative day. Full weight bearing after x‑ray and clinical control after 6weeks. Since 2016 eight tibial PCL avulsions were treated. In 6patients asuture-bridge technique via amini-open approach was performed due to asmall or comminuted fracture fragment. In 2patients an all-arthroscopic technique was performed. No complications. The all-arthroscopic technique requires asolid fragment and enables the surgeon to treat additional pathologies. In general, the arthroscopic technique makes the open posterior approach unnecessary. The arthroscopic techniques achieve slightly higher objective and subjective values compared to the open procedure, despite ahigher rate of arthrofibrosis.