A modified bone-tendon-bone harvesting technique for avoiding tibial tunnel-graft mismatch in anterior cruciate ligament reconstruction.

Anatomic graft fixation in anterior cruciate ligament reconstruction has been shown to be extremely important for achieving acceptable postoperative knee stability. Different methods have been proposed for customizing graft length, so that anatomic graft fixation is obtained at the native anterior cruciate ligament site. A technique has been described for avoiding potential complications during the insertion of an interference screw at femoral tunnel and, ultimately, reducing the mismatch within the femoral tunnel. The aim of this article is to present a modified application to the tibial tunnel of a previously described technique for avoiding graft-tunnel mismatch. The advantages are related to the increase in graft complex stiffness, achievement of a more anatomic fixation, and the reduction in synovial fluid leakage.