Anterior Cruciate Ligament Reconstruction: Two-Incision Technique

The anterior cruciate ligament is the most frequently reconstructed ligament of the knee. Recently there has been increased focus on the importance of reproducing the anatomy of the femoral attachment to restore stability, along with increased concerns that drilling the femoral tunnel through the tibial tunnel more frequently results in a too vertical femoral tunnel. We present a description of our 2-incision operative technique for reconstruction of the anterior cruciate ligament with bone-patellar tendon-bone autograft. This technique allows almost unlimited control of femoral tunnel position in the notch while drilling the femoral tunnel through a small (2 cm) lateral incision. With careful attention to detail in all phases of the operation and effective rehabilitation, complications are minimized and consistent outcomes can be expected.