Specialized Toolkit Series: ACL Reconstruction-Drilling the Tibial Tunnel

Drilling the Tibial Tunnel

Video Transcription

Video Summary

Dr. Patrick Joyner explains two techniques for drilling the tibial tunnel in ACL reconstruction: the outside-in (trans-tibial) and inside-out (retrograde). The outside-in method involves starting from the outside tibia and drilling inward, with fluted reamers recommended for bone plug grafts and acorn reamers for flexibility in tunnel direction. The inside-out method uses a retrograde reamer, placing the guide on the ACL footprint and drilling backward. Hybrid reaming can adjust tunnel trajectory if needed. Dr. Joyner prefers the outside-in technique and emphasizes the importance of smooth tunnel creation for successful graft passage.

Asset Caption

Patrick Wakefield Joyner, M.D., M.S., FAANA

Meta Tag

Concept ACL Reconstruction

Concept Tibial Tunnel

Concept Retrograde Tibial Tunnel Drilling

Concept Anatomic Femoral ACL Footprint

Concept Outside-In Drilling

Keywords

ACL reconstruction

tibial tunnel

outside-in technique

inside-out method

Dr. Patrick Joyner

ACL Reconstruction

Tibial Tunnel

Retrograde Tibial Tunnel Drilling

Anatomic Femoral ACL Footprint

Outside-In Drilling