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single bundle acl reconstruction medial portal technique a detailed didactic presentation introduction an atomic placement of an anterior cruciate ligament acl graft is critical to the success and clinical outcome of acl reconstruction anatomic acl graft placement is defined as positioning the acl femoral and tibial bone tunnels at the center of the native acl femoral and tibial attachment sites clinical studies have demonstrated that non-anatomic acl graft placement is the most common technical error leading to recurrent instability following acl reconstruction acl reconstruction has been commonly performed using a transtibial technique in which the acl femoral tunnel is drilled through a tibial tunnel positioned in the posterior half of the native acl tibial attachment site in the transtibial technique positioning the acl tibial tunnel in the posterior half of the acl tibial attachment site is dictated by the need for the endoscopic drill bit to docHub the region of the acl femoral a