The arthroscopic "impingement test" during anterior cruciate ligament reconstruction

A primary goal of ACL reconstruction is to avoid graft impingement, which may lead to loss of motion and/or an increased incidence of instability. Although surgeons are cognizant of this potential problem, the intraoperative correction of graft impingement is technically demanding because the graft-notch relationship is obscured by the trochlea articulating with the tibial plateau during the final 10 degrees of extension. We present a simple impingement test that is performed before graft insertion and fixation to help avoid this potential pitfall.