Fig. 3.

ACL reconstruction tunnel placement has evolved circuitously over the previous three decades. In the 1980s, ACL bone tunnels were placed anatomically utilizing outside-in jigs and mini-open or open techniques. In the 1990s, arthroscopic assisted transtibial techniques were popularized, but femoral tunnels were placed in a non-anatomical anterior (“high AM”) position. In the early 2000s, double-bundle techniques were introduced to our institution. The PL bone tunnel was drilled anatomically via the accessory medial portal, but the femoral AM bone tunnel was drilled via the tibial AM tunnel resulting in a non-anatomic anterior (“high AM”) position once again. Our anatomical knowledge has further improved since that time, and we have subsequently placed our bone tunnels anatomically into the native ACL insertions