1. Applying Cross-Pin System in Both Femoral and Tibial Fixation in Anterior Cruciate Ligament Reconstruction Using Hamstring Tendons 
Wei Qi, M.D., Yujie Liu, M.D., Jing Xue, M.D., Haifeng Li, M.D., Junliang Wang, M.D., Feng Qu, M.D. 
Arthroscopy Techniques 
Volume 4, Issue 5, Pages e397-e402 (October 2015)
DOI: /j.eats
Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

2. Fig 1
Care is taken to pre-tension the 4 or 6 strands uniformly, and the tibial and femoral portions of the tendon graft are both sutured together to achieve 30 to 35 mm under pre-tensioning.
Arthroscopy Techniques 2015 4, e397-e402DOI: ( /j.eats )
Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

3. Fig 2
(A) The end of the 2.4-mm guide pin (GP) is parallel to the articular entrance (AE) at the lateral condyle (LC) of the femur. (B) The minus method is used for measurement of the femoral tunnel length. Another 2.4-mm guide pin (GP′), whose length is equal to that of GP, is inserted to touch the cortex (white arrow) of the LC by the side of GP, and the length between the tip of GP and the end of GP’ (yellow double-headed arrow) is the length of the femoral tunnel.
Arthroscopy Techniques 2015 4, e397-e402DOI: ( /j.eats )
Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

4. Fig 3
(A) To determine whether the position of the cross pin in the tunnel is correct, the guide pins (arrows) are inserted into the holes for the cross pin, and the surgeon observes whether they are located in the center of the cross section of the tunnel with an arthroscope inserted into the tunnel. (B) The arrows show that the cross pins have missed the center of the tunnel.
Arthroscopy Techniques 2015 4, e397-e402DOI: ( /j.eats )
Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

5. Fig 4
(A) To make the cross-pin holes a little lower than the tibial plateau (TP), the top of the guide is paralleled to the level of the subchondral bone (SCB) at the proximal entrance of the tibial tunnel (about 5 mm below the articular surface of the tibial plateau). The double-headed arrow shows the thickness of the subchondral bone. (B) The jig of the guide frame is placed on the anterolateral side of the right tibia (arrow) to create the tibial tunnel.
Arthroscopy Techniques 2015 4, e397-e402DOI: ( /j.eats )
Copyright © 2015 Arthroscopy Association of North America Terms and Conditions

6. Fig 5
Flow diagram showing steps of tibial and femoral RigidFix Cross Pin fixation technique using semitendinosus (SMT) and gracilis (G) tendon graft for anterior cruciate ligament (ACL) reconstruction. Symbols with a solid arrow indicate activity performed by the surgeon; symbols with a dashed arrow indicate activity optionally performed by the assistant.
Arthroscopy Techniques 2015 4, e397-e402DOI: ( /j.eats )
Copyright © 2015 Arthroscopy Association of North America Terms and Conditions