Techniques to avoid tibial tunnel influence on femoral tunnel malposition in ACL reconstruction

Anterior cruciate ligament (ACL) reconstructions are one of the most common orthopedic surgeries performed. Traditional techniques of reconstruction involved femoral tunnel drilling using a transtibial approach. Recent studies have suggested that drilling a femoral socket through the anteromedial portal can increase the obliquity of the tunnel and more accurately recreate the anatomy of the native ACL. Several technical tricks can be used to avoid complications associated with this technique. This study describes the preoperative assessment, surgical procedure, postoperative rehabilitation, and potential pitfalls of ACL reconstruction using an anteromedial portal drilling technique to create the femoral tunnel.