Femoral and Tibial Tunnel Position Using a Transtibial Drilled Anterior Cruciate Ligament Reconstruction Technique

ABSTRACT

This study evaluates the position of the femoral tunnel, which is achieved using a transtibial, single-bundle anterior cruciate ligament (ACL) reconstruction technique. The radiographs of 50 consecutive, primary single-bundle ACL reconstructed knees using this technique were reviewed. The angle between the femoral tunnel and the apex of the intercondylar notch was recorded. The average angle from the 12-o'clock vertical position to the femoral tunnel was 49° (range, 39°-59.2°; SD = 3.9), corresponding to the 10:20 position on a clock face for a right knee. These results demonstrate that it is technically possible to create an obliquely oriented single-bundle femoral tunnel at approximately the 10:20 position through a tibial tunnel angled approximately 60° from the proximal tibial joint surface. This correlates to a femoral tunnel approximately midway between the anteromedial and posterolateral bundle origins of the ACL.