Femoral bone plug recession in endoscopic anterior cruciate ligament reconstruction

Graft tunnel mismatch is a constant challenge in endoscopic ACL reconstruction with bone-patella tendon-bone allograft. Strategies for addressing this situation on the tibial side which include staple or suture fixation may compromise the postoperative pullout strength of the graft. We describe our technique for recession of the femoral bone plug as a solution to this problem and present our preliminary experience in a series of 100 consecutive patients followed-up to 1 year. Interference screw fixation was consistently achieved in both tunnels and recession did not influence anterior-posterior displacement by KT arthrometry.