Answer: Once the decision has been made on which ACL graft to use there are further considerations with regards to where to put it! knee surgeons cannot agree on the ideal position for the ACL graft. Historically, the position of the graft was dictated by our ability to perform the surgery and 10 to15 years ago the graft was put in a very vertical position, which is different from the normal ACL. This position is attained with a technique called trans-tibial drilling, where the surgeon drills a hole in the shin bone (tibia) first, and then drills through this into the thigh bone. Thus, the position of the tibial hole determines the position of the femoral hole. Some surgeons still use this old technique and report good results.
Related articles
Mr Charles Willis-Owen
Consultant Orthopaedic Surgeon