Fig. 9.

A more lateral placement of the AAM portal results in a more oblique orientation of the spinal needle relative to the lateral wall of the notch. This orientation will produce a more elliptically shaped aperture of the femoral tunnel and a longer femoral tunnel length. Based on the ACL graft type and femoral fixation method, the position of the AAM portal is adjusted to achieve the desired ACL femoral tunnel length. For example, if a bone-patellar tendon-bone ACL graft with interference screw fixation of the femoral bone block is used for the ACL reconstruction, the optimal femoral tunnel length can be in the range of 25–30 mm. For this graft type and fixation method, the AAM portal can be positioned more medially compared to an ACL reconstruction performed using a multiple-strand hamstring tendon graft with ENDOBUTTON femoral fixation