The ACL tibial footprint is the attachment zone on the anterior tibial plateau, centred in the anterior intercondylar area between the tibial spines. It is a broad, oval region approximately 11mm in the AP direction and 17mm in width.
Provides the tibial anchor for the ACL, transmits the ACL restraining force to the proximal tibia, and is the area where tibial tunnel placement in ACL reconstruction is critical for biomechanical graft function.
ACL tibial tunnel placement must be within the native footprint centre — anterior placement (tibial tunnel) causes roof impingement on the PCL in full extension. The posterior aspect of the ACL tibial footprint (posterolateral bundle footprint) is the reference for anatomic single-bundle reconstruction.
The ACL tibial footprint centre guides tibial tunnel positioning in ACL reconstruction — anterior tunnel placement causes notch roof impingement while posterior placement produces graft laxity in extension.
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