Precision in Reconstruction of the Anterior Cruciate Ligament. A New Positioning Device Compared with Hand Drilling

To evaluate the precision of a drill guide for use in anterior cruciate ligament reconstruction and the reproducibility of the results, the device was tested in 30 operations (Group 1); 17 operations were done freehand (Group 2); 10 cadaver knees served as anatomic controls. The internal orifices of the bony channels in Groups 1 and 2 and the central point of the anterior cruciate ligament attachments in the cadaver group were identified on lateral radiographic views. The position of the tibial ligament attachments in the cadaver group did not differ from the orifices of the drilled channels in Groups 1 and 2. The position of the femoral attachments in the cadaver group did not differ from the orifices of the drilled channels in Group 1, but between the cadaver group and Group 2, and Groups 1 and 2, the positions of the femoral attachments differed. The hand-drilled channels were generally located too far anteriorly, and the scatter of the attachments was 1.8 times greater. The drill guide enables reproducible anatomic positioning of an anterior cruciate ligament graft.