Abstract
Press-fit techniques for arthroscopic ACL replacement have been developed to avoid problems and complications related to the use of interference screws. Improper insertion of screws may reduce primary stability, injure the posterior femoral cortex, or displace hardware into the joint. Most techniques described use press-fit on either the femoral or tibial side. To avoid any supplemental fixation material an arthroscopic method was developed which achieves patellar tendon autograft fixation by press-fit on both sides. On the femoral side angling of the patellar bone block in relation to the direction of ligament tension increases pullout strength. On the tibial side the oversized bone block anchors with progressive strength in the cylindrical tibial tunnel creating an ideal environment for osseous integration. Concurrently, a stable fixation is achieved allowing early functional rehabilitation. However, fixation strength depends on bone quality and the arthroscopic procedure is demanding.
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