Technique for Creating the Anterior Cruciate Ligament Femoral Socket: Optimizing Femoral Footprint Anatomic Restoration Using Outside-in Drilling

Comparison of graft bending angle during knee motion after outside-in, trans-portal and trans-tibial anterior cruciate ligament reconstruction

“…Currently, OI and TP techniques are popular techniques for drilling femoral tunnels in anatomic ACL reconstruction [8,9,12,20,25,29,30,32,34,51,54,56], and modified TT technique has been also reported to achieve anatomic placement of the grafts within ACL footprint [14,58,59]. Recent studies on GBA evaluated by postoperative CT have reported that OI technique resulted in more steep GBA than in TP technique, with about 80° GBA by OI technique [23,40,50], and these results were similar to our findings at full extension.…”

Creation of an Anatomic Femoral Tunnel With Minimal Damage to the Remnant Bundle in Remnant-Preserving Anterior Cruciate Ligament Reconstruction Using an Outside-In Technique

“…4,5 However, another important point to consider is an anatomic reconstruction at the footprint of the native ACL. [6][7][8][9][10] After remnant-preserving ACL reconstruction, the position of the femoral tunnel was not satisfactory and it was supposed to be positioned slightly to the anterior side, compared with our expectation, even though good clinical results were achieved. 1,4,11 Recently, the trans-portal technique has become popular with creation of the femoral tunnel at the anatomic position.…”

Optimal Femoral Tunnel Positioning in Posterior Cruciate Ligament Reconstruction Using Outside-in Drilling

“…A similar technique has been previously described to analyze tunnel length and graft footprint characteristics for anterior cruciate ligament femoral socket placement. 16 Digitization began by defining the femoral axis in the axial plane (Fig 2) and the transepicondylar axis in the coronal plane (Fig 3). Points along these axes were digitized for use as anatomic landmarks using the MicroScribe G2 3-dimensional digitizing system (Immersion, San Jose, CA).…”