Abstract
Endoscopic methods of ACL reconstruction have shown some disadvantages such as the inability to freely position the femoral tunnel. Moreover, this technique dictates relatively vertical and central non anatomical graft placement compared to the more horizontal and lateral course of the native ACL. The ACL presents a collection of individual fibers that are grouping in two distinct bands, anteromedial (AM) and posterolateral (PL). The most anterior fibers of AM band are the most isometric. The majority of ACL fibers lie posteriorly to the isometric point on the medial wall of the femoral condyle. These fibers are lax during flexion and tight in extension. This behaviour was defined “favourable non isometry”. The “favourable non isometry” is very interesting because increased knee loading often occurs at flexion angles of less than 60 degrees. Classic two-incision technique, using a rear-entry drill, our two-incision technique, or the Clancy anatomic endoscopic technique using flexible reamers and use of different not commonly arthroscopic portals seems to allow a predictable, near-anatomic placement of femoral tunnel.
Correspondence should be addressed to Ariella Neustadt at Studio EGA, Professional Congress Organisers, Viale Tiziano, 19 - 00196, Rome - Italy.
