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Specialized Toolkit Series: ACL Reconstruction
Drilling the Tibial Tunnel
Drilling the Tibial Tunnel
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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
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Anatomic Femoral ACL Footprint
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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
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