ACL reconstruction using three approaches

Anterior cruciate ligament reconstruction has commonly been performed using a technique where the femoral tunnel is drilled or positioned in the posterior half of the native ACL. This results in a vertical graft that may not control the combined movements of anterior tibial translation and internal tibial rotation. This can lead to instability-related symptoms in patients. We describe the technique of anterior cruciate ligament grafting using a third accessory medial anterior approach through which the femoral tunnel is drilled into its correct position.