Fig 3.

Tibial tunnel formation in left knee (lateral view). (A) Exposure of anterolateral tibial flat spot (arrow) between Gerdy tubercle and tibial tubercle. (B) Positioning of tibial aiming guide (arrow). The posterior tunnel emergence should be 1 cm medial and 1 cm proximal to the posterior fibular tunnel opening. (C) With manual reduction of the proximal tibiofibular joint, by use of a posterior retractor and tibial aiming guide, a 2.4-mm guide pin (arrow) is placed through the posterior aspect of the tibia. (D) Final tibial tunnel formation with 6-mm cannulated reamer (arrow) over guide pin. It should be noted that the Chandler retractor remains in place throughout tunnel formation and proximal tibiofibular joint reduction is maintained.