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Anatomic ACL reconstruction

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Dr Charles H Brown, Jr

Knee Surgeon

Dr Charles Brown specializes in knee ligament and meniscus surgery. His special knee interests include: arthroscopic knee surgery and meniscus and knee ligament injuries. He is a leading authority on cruciate knee ligament and meniscus injuries. He is currently the Director of the International Kne…

October 1, 2023

A brief discussion about where to place the new ACL graft for best success.

Positioning of the ACL reconstruction is critical to success

Discussion in 2015 with the Clinical Editor Dr Sheila Strover

Anatomic ACL reconstruction

  • The debate continues about where in the femoral footprint the graft should be placed
  • The point is that the footprint is larger than the drill hole, so it has to be decided where on the footprint one should make the tunnel
  • Surgeon technique is important as the correct use of portals and knee position optimise access to the footprint
  • Use of posts to hold the knee during surgery allow exact positioning without assistance
  • If the remnant is being preserved, it is useful to use fluoroscopy to position the tunnels as the remnant obscures the view (but too much remnant may lead to a cyclops lesion)