Drill hole position in endoscopic anterior cruciate ligament reconstruction. Results of an advanced arthroscopy course.

In 24 cadaver knees the anterior cruciate ligament (ACL) was replaced by a bone-tendon-bone patellar tendon autograft in an endoscopic technique. This was carried out during an advanced arthroscopy course after intensive instruction and practice on a plastic model. When the knees were opened and evaluated according to the recent orthopaedic literature, only four good results with correct tunnels and a non-impinging graft were found. In 12 knees the femoral tunnel was too far anterior (10) or had broken through the posterior femoral cortex (2). In 6 knees the tibial tunnel was too far anterior (2) or too far posterior (4). The notchplasty was insufficient in 6 knees. We conclude that endoscopic ACL reconstruction cannot be mastered after attending a course alone. Expert help is necessary during the first clinical cases.