Advances in the three-portal technique for anatomical single- or double-bundle ACL reconstruction.

Abstract

To describe the "three-portal technique for anatomical ACL single- or double-bundle reconstruction" and the arthroscopic viewing improvement provided by this technique. A "high" anterolateral portal was placed 1 cm lateral to the patellar tendon and the most inferior portion of the portal at the level of the inferior pole of the patella. A "central" portal was placed using a spinal needle under arthroscopic visualization following the orientation of the previous ACL fibers. An accessory medial portal was also placed using a spinal needle respecting a 2-mm distance to the medial femoral condyle. The "high" anterolateral portal permitted a broad and unobstructed view of the ACL tibial attachment. The "central" portal allowed a straightforward view of the ACL femoral remnant and bony landmarks in the intercondylar notch. The accessory medial portal enabled to reach the femoral native insertion site of the ACL. The three-portal technique provides a proper view of the soft tissue remnants and bony landmarks facilitating an anatomical positioning of the graft.