Fig 8.

Femoral tunnel preparation. (A) Perforation of femoral tunnel using standard outside-to-inside technique. The femoral tunnel is drilled first to prevent the loss of arthroscopic fluid. The knee is taken into hyperflexion to facilitate visualization, and the arthroscope is inserted through the anterolateral portal. A femoral aiming guide (I) is placed through the anteromedial portal at the desired anchoring point (II). Because our technique includes an extra-articular reinforcement of the lateral ligament, the lateral entry point of the guidewire is located immediately anterior to the lateral femoral epicondyle (III). (B) Intraoperative clinical image showing femoral aiming guide (I) introduced through anterolateral portal (II) with guidewire (III) already placed in desired orientation. The lateral femoral entry point is located slightly anterior in relation to the lateral femoral epicondyle (IV).