Use of an endoscopic aimer for femoral tunnel placement in anterior cruciate ligament reconstruction.

Accurate placement of the femoral tunnel is a technically difficult aspect of anterior cruciate ligament reconstruction. Various drill guides have been developed to aid in the selection of this site. The purpose of this article is to describe a new drill guide designed to ensure anatomic placement of the femoral tunnel. The guide is used as part of a single-incision arthroscopic anterior cruciate ligament reconstruction technique with a bone-patellar tendon-bone graft secured with interference screws. An intraoperative check of the "pretunnel footprint" can be made to verify correct placement by the remaining cortical margins measurement within an acceptable 1 to 2 mm range before drilling the tunnel to depth. If necessary, minor adjustments to the guidepin location can be made to prevent posterior tunnel margin dimensions of less than 1 mm (troughing) or greater than 2 mm.