1. A Surgical Trick for Adjusting an Inaccurate Guide Pin to the Center of the Tibial Footprint in Anatomic Single-Bundle Anterior Cruciate Ligament Reconstruction 
Adinun Apivatgaroon, M.D., Bancha Chernchujit, M.D. 
Arthroscopy Techniques 
Volume 3, Issue 2, Pages e275-e277 (April 2014)
DOI: /j.eats
Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

2. Fig 1
If the pin is in the center of the tibial footprint, we ream the tunnel with a reamer that is the same diameter as the graft.
Arthroscopy Techniques 2014 3, e275-e277DOI: ( /j.eats )
Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

3. Fig 2
If the pin is not centered in the tibial footprint, we ream the tunnel using the smallest reamer found; we then adjust the drill guide to the center and incrementally ream the tunnel until the center of the tibial footprint is reached.
Arthroscopy Techniques 2014 3, e275-e277DOI: ( /j.eats )
Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

4. Fig 3
Incremental reaming technique in Sawbones model (Pacific Research Laboratories, Vashon, WA) of left knee. We used straight clamps to adjust the position of the guide pin toward the center of the footprint before incrementally reaming the tunnel.
Arthroscopy Techniques 2014 3, e275-e277DOI: ( /j.eats )
Copyright © 2014 Arthroscopy Association of North America Terms and Conditions

5. Fig 4
Arthroscopic view from anterolateral portal of left knee. After we have inserted the guide pin through the tibial footprint, reaming the tibial tunnel with a small-diameter reamer, we use straight clamps to adjust the position of the guide pin toward the center of the footprint before incrementally reaming the tunnel. The red arrow shows the direction of adjustment.
Arthroscopy Techniques 2014 3, e275-e277DOI: ( /j.eats )
Copyright © 2014 Arthroscopy Association of North America Terms and Conditions