Incidence of the Remnant Femoral Attachment of the Ruptured ACL

The presence of remnant tibial and femoral attachments of the ruptured ACL has been described in the literature but the femoral remnant has not been well described as a landmark for tunnel placement during reconstruction. We reviewed operative reports, pictures, and videotapes from 111 ACL reconstructions to determine the incidence of a remnant femoral stump. Patients were divided into two groups: Group A included patients treated from January 2006 through September 2006 (n = 63) when the presence of the femoral footprint was documented retrospectively and Group B included patients treated from September 2006 through June 2007 (n = 48) when the presence or absence of the femoral footprint was documented prospectively. In Group A, there were 48 of 58 (83%) patients with a visible stump and 10 (17%) patients in whom we could not verify the existence of the stump. In Group B, 43 of 44 (98%) patients had a visible stump on the lateral femoral wall that was adequate as a guide for femoral tunnel placement. The native femoral footprint is seen in most cases of ACL reconstruction and can be used for guidance during femoral tunnel preparation.