For patient positioning during ACL reconstruction, we use a hip post and a foot rest. You will require two socket clamps to secure these to the edge of the operating table. The image on the right shows the hip post and foot rest attached. These images demonstrate the hip post and foot rest positioning the knee at 90 degrees of flexion as well as at full extension. A tourniquet has been applied to the proximal thigh and the patient is positioned on the operating table such that his feet extend just to the end of the table. This video demonstrates the ability to adjust the position of the limb from hyperextension to 90 degrees of flexion to hyperflexion to 110 to 120 degrees. We typically use patellar tendon autograft for ACL reconstruction, but this patient positioning also allows for access to quadriceps tendon harvest as well as hamstring tendon harvest. We normally use intramedial drilling for femoral tunnel placement and hyperflexion to 100 to 120 degrees is utilized and this is easily performed with this patient positioning technique. Additionally, we use a breakaway post when necessary to apply additional lateral support during valgus stress testing.

ACL reconstruction

patient positioning

hyperflexion

femoral tunnel

valgus stress testing

hip post

knee flexion

surgical techniques