Transtibial Anterior Cruciate Ligament Reconstruction: Tips for a Successful Anatomic Reconstruction

Anterior cruciate ligament (ACL) reconstruction is one of the most commonly performed orthopaedic sports procedures. Two main techniques are used for accomplishing an ACL reconstruction: transtibial and anteromedial portal techniques. The transtibial technique has been criticized for its inability to create an anatomic femoral tunnel given the intrinsic constraint of the tibial tunnel during drilling. However, technical modifications of the transtibial technique can result in anatomic tunnel entrance positioning and a properly oriented graft. This Technical Note presents our technique for anatomic transtibial ACL reconstruction.
Technique Video Video 1 This video describes our tips for a successful anatomic trans-tibial anterior cruciate ligament reconstruction (ACL). The steps highlight the technical modifications that can be implemented in the technique to help replicate the native anatomy by ensuring anatomical positioning of the tunnel entrance and proper orientation of the ACL graft.