1. Anatomic Anterior Cruciate Ligament Reconstruction With a Flexible Reamer System and 70° Arthroscope 
Jeffrey F. Rasmussen, M.D., Kyle P. Lavery, M.D., Aman Dhawan, M.D. 
Arthroscopy Techniques 
Volume 2, Issue 4, Pages e319-e322 (November 2013)
DOI: /j.eats
Copyright © 2013 Arthroscopy Association of North America Terms and Conditions

2. Fig 1
While one is visualizing through the AL portal, a Clancy curved drill guide is introduced through the AM portal, ensuring that its tip rests in the middle of the ACL femoral footprint. The entry point for the guidewire should be located inferior to the lateral intercondylar ridge and directly onto the bifurcate ridge (when performing an anatomic single-bundle technique) and approximately 7 mm superior to the inferior chondral junction.
Arthroscopy Techniques 2013 2, e319-e322DOI: ( /j.eats )
Copyright © 2013 Arthroscopy Association of North America Terms and Conditions

3. Fig 2
A flexible passing pin is inserted through the curved drill guide and advanced through the femoral condyle until it exits the distal thigh. Sounding of the lateral femoral outer cortex is performed, much as it is in fracture drilling, to obtain the intraosseous length.
Arthroscopy Techniques 2013 2, e319-e322DOI: ( /j.eats )
Copyright © 2013 Arthroscopy Association of North America Terms and Conditions

4. Fig 3
The Clancy flexible reamer is inserted through the AM portal over the passing pin. Directly visualizing passage of the reamer across the medial femoral condyle will help avoid iatrogenic injury to the medial femoral condyle.
Arthroscopy Techniques 2013 2, e319-e322DOI: ( /j.eats )
Copyright © 2013 Arthroscopy Association of North America Terms and Conditions

5. Fig 4
The prepared ACL graft is loaded onto the EndoButton and passed retrograde through the tibial tunnel back into the knee and then into the femoral tunnel. A probe or looped grasper should be used to help lever the pulling sutures and help navigate the graft through the intercondylar notch and into the femoral tunnel aperture.
Arthroscopy Techniques 2013 2, e319-e322DOI: ( /j.eats )
Copyright © 2013 Arthroscopy Association of North America Terms and Conditions