Femoral Tunnel Placement in Anterior Cruciate Ligament Reconstruction

Technical failures with anterior cruciate ligament reconstructions occur in large part from errors in femoral tunnel placement. Recent research questions our knowledge of femoral tunnel placement. Based on newer biomechanical studies, the traditional method of placing the graft in the 11-o’clock position in the right knee restores anterior stability but not rotational stability. In addition, the kinematics of the knee may be abnormal after anterior cruciate ligament reconstructions. We review the literature on the anatomic attachment site and the biomechanical studies. These studies provided the impetus for the development of the senior author’s current method of anterior cruciate ligament reconstruction.