Anteromedial Portal Reference Technique for Femoral Tunnel Depth Measurement During Arthroscopic Anterior Cruciate Ligament Reconstruction

Abstract

Femoral tunnel preparation during the anterior cruciate ligament reconstruction is a technically demanding step. The anteromedial (AM) portal technique necessitates knee hyperflexion during the femoral tunnel reaming. In a hyperflexed knee, the arthroscopic visualization of the laser markings on the femoral tunnel reamer becomes obscured. Thus, the calculation of the depth of the femoral tunnel becomes difficult. Our technique helps in femoral tunneling reliably without the need for arthroscopic visualization using the AM portal as a reference point to calculate the depth while drilling. This technique can be performed without the need for a second assistant to hold the arthroscope. Furthermore, this technique does not require any specific instruments, and there is no obligation for an additional incision.

Weight Is a Predictor of Delayed Operation Time in Primary Isolated Anterior Cruciate Ligament Reconstruction

“…Furthermore, our study used the anteromedial portal femoral drilling technique, which usually requires deep knee flexion greater than 120° during femoral tunnel preparation [ 30 , 31 ]. The anteromedial portal femoral drilling technique itself could cause arthroscopic apparatus crowding in the operation field and block the arthroscopic view [ 32 , 33 , 34 ]. This condition could be much worse in patients with obesity than in normal-weight patients.…”