ABSTRACT
Anterior cruciate ligament (ACL) reconstruction techniques continue to improve. Recent
biomechanical studies have found improved rotational stability as femoral tunnel placement
becomes more horizontal and closer to the true ACL footprint. Clinical studies also
correlate improved outcomes with these more anatomic reconstructions. This article
reviews the transition from traditional to anatomic ACL reconstructions, as well as
3 techniques for achieving this: the modified transtibial technique, use of an accessory
medial portal, and the retrograde drilling technique.
