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Rescue option when patellar tendon length is up to 5 cm. In this situation, there is a risk of not being able to tighten the Pullup XL device, even though the Pullup loops are reduced to a minimum. The Pullup XL device should be tightened on a 6-mm-wide staple inserted in the tibial epiphysis, 1.5 cm away from the tibial tunnel external aperture. It should be helpful to drill the longest femoral tunnel as is acceptable to increase the length of the graft inside the femoral tunnel.
