Abstract
Anatomic orientation of the graft in anatomic anterior cruciate ligament reconstruction is the key to improved knee stability, restoration of normal knee kinematics, and the prevention of long-term joint degeneration. The graft position and orientation in the joint depend on the position of the tibial and femoral tunnels. Graft displacement in the tibial tunnel due to the position of the interference screw when the screw has proximal fixation also has an effect on the orientation of the graft. We have developed a technique for adjusting guidewire placement for the interference screw posterolaterally in the tibial tunnel in anatomic single-bundle anterior cruciate ligament reconstruction. This technique helps to push the graft medially and anteriorly in the tibial tunnel, avoids impingement of the graft with the lateral femoral condyle, and helps to maintain the orientation of the graft in a more anatomic way.