“Retrograde Technique” for Drilling the Femoral Tunnel in an Anterior Cruciate Ligament Reconstruction

Abstract

Recent literature has led some surgeons to drill the femoral tunnel in an anterior cruciate ligament reconstruction through an accessory anteromedial portal. Several techniques have been reported for the safe, effective drilling of the femoral tunnel by this approach. This technical note presents a new "retrograde technique" in which all instruments are passed independently into the notch and across the medial compartment. This technique is safe and reproducible and allows for meticulous evaluation and creation of the femoral tunnel(s) while minimizing steps.

Peak stresses shift from femoral tunnel aperture to tibial tunnel aperture in lateral tibial tunnel ACL reconstructions: a 3D graft-bending angle measurement and finite-element analysis

“…Nevertheless, tunnel orientation can vary (DGA and transverse angle) [4–6, 48, 49, 54]. Recent technical developments enable for outside‐in or retrograde femoral tunnel drilling in ACL surgery [55–57]. These techniques allow for very precise tunnel placement at the level of the native femoral ACL footprint as desired in anatomic ACL surgery.…”

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

“…The outside-in technique also avoids hyperflexion of the knee; however, this technique requires additional skin incision over the lateral aspect of the distal thigh [ 1 ]. Lately, a retrograde drilling device has been introduced to avoid this extra skin incision [ 4 ]. However, the retrograde drilling device or the flexible guide-pin and reamer are not available in a traditional setting and increase the cost of the procedure.…”

Prevention of Medial Femoral Condyle Injury by Using a Slotted Cannula in Anterior Cruciate Ligament Reconstruction

“…Fourth, according to the surgical technique described by Branam and Hasselfeld 12 in 2013, the guide pin is inserted at the anatomic position of the femoral ACL attachment and advanced through the femoral skin until the position of 5 to 10 mm projecting from the femoral attachment is reached. The tip of the drill bit is inserted to interdigitate the guide pin.…”