Endoscopic ACL reconstruction.

The endoscopic technique offers the advantage of one incision and a femoral osseous tunnel trajectory that is more in line with the collagen fibers of the graft. Technically, it is more demanding to reproducibly obtain the interference fixation than using the two-incision technique. There is a tendency for screw and graft divergence in the femoral tunnel. The exact clinical significance of this screw and bone plug divergence has yet to be clarified. Surgeons must assess their ability to obtain the best results for the patient. There is a definite learning curve for the endoscopic technique. We believe that, with further advances in instrumentation, fixation, and alternative grafts, it will eventually be the approach of preference for ACL reconstructions.