A new positioning device for precise femoral insertion of the anterior cruciate ligament autograft

Abstract

Optimal anatomical replacement of anterior cruciate ligament (ACL) is essential for achieving knee stability. Several methods for localizing a correct center of femoral insertion of the ACL graft and identifying a center of the femoral tunnel have been proposed, including free-hand drilling with "eyeballing," the use of tensiometers or isometers, fluoroscopic or radioscopic control, and aiming devices. We present a new positioning device for precise femoral insertion of the ACL autograft based on preoperative radiographic measurements (quadrant method) for locating the femoral ACL insertion. The aim was to find the best placement in the individual knee considering the wide variations among individuals and to decrease the likelihood of the surgeon making a mistake in localizing the optimal position of femoral insertion of the ACL. In comparison to other positioning procedures this method provides an exact preoperative planning of femoral insertion of the ACL and eliminates numerous sources of errors.