Anatomical Single-Bundle Transtibial Anterior Cruciate Ligament Reconstruction

Anatomical anterior cruciate ligament (ACL) reconstruction is a reasonable transition from isometric ACL reconstruction to obtain better clinical outcomes, and most authors believe that it can only be performed through the medial portal technique. However, in our clinical practice, we found that anatomical ACL reconstruction can be performed easily and accurately by creating a tibial tunnel, which is accomplished by setting the tibial tunnel with correct angulation to the sagittal plane and tibial axis. Hence, we introduce this special transtibial anatomical ACL reconstruction technique, in which the most critical step is the creation of a shallow tibial tunnel with a proximal projection to the anatomical location of the femoral tunnel. This technique is indicated for primary ACL reconstructions in skeletally mature patients. We believe this Technical Note will give a special view on anatomical ACL reconstruction.