Fig 2.

The patient is in the supine position with the left leg draped with an extremity drape. (F, femur; P, patella; T, tibia.) (A) An image from the right side of the patient with the skin incision marked on the superior and medial aspect of the left patella. (B) The skin is incised, and dissection is completed down to the patella; the guidewire for reaming the patellar tunnel is then placed at the junction of the middle and proximal third of the patella. (C) A fluoroscopic lateral image of the left knee is then obtained to localize the guidewire for proper drilling of the patella at the middle and superior third. (D) The patella is reamed to create the tunnel on the medial aspect (arrowhead) using a 5-mm reamer to ream a tunnel with a length of 20 mm, as pictured.