Document Type


Publication Date

March 2007


This article has been peer reviewed. It is the authors' final version prior to publication in Arthroscopy 23(3):325.e1-5, March 2007; Epublished ahead of print on January 18, 2007. The published version is available at DOI: 10.1016/j.arthro.2006.07.030. Copyright © 2007 Arthroscopy Association of North America, published by Elsevier, Inc.


Standard endoscopic reconstruction of the anterior cruciate ligament (ACL) is performed with the use of 2 arthroscopic portals. The surgical error most commonly associated with ACL reconstruction is improper positioning of the tunnel. Errors in femoral tunnel position may be related to poor visualization of the lateral wall. When anatomic double-bundle ACL reconstruction is performed, proper visualization of the lateral wall is essential to ensure correct placement of both tunnels. We propose the use of a central portal, in addition to more standard anterolateral and anteromedial portals, to enhance visualization of the lateral wall. In addition, the arthroscope can be moved interchangeably throughout the portals during the procedure for improved viewing during specific steps. An accessory anteromedial portal placed inferiorly and medially allows placement of the femoral tunnels while providing a high central anteromedial portal for best visualization of the lateral wall. As a result, no notchplasty is required, and a more anatomic reconstruction can be performed.

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