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demonstrating an ACL ligament reconstruction in the knee using a graft there are three bones that meet to form the knee the femur or the thigh bone the tibia were the shin bone and the patella or the kneecap these bones are held together by strong rope like tissues called ligaments one of the ligaments is called the ACL anterior cruciate ligament which is in the middle of the knee joint and helps stabilize the knee in front to back and rotational motions a common injury to the ACL is a sprain or a tear first the surgeon places the drill guide on the femur and locks it in place the drill guide is placed against the bone the drill begins drilling through the femur from outside of the joint to the inside of the joint after removing the guide the drill sleeve is tapped into the femur then the blade at the end of the drill pieces are opened into the cutting position and drilled into the bone creating a hollow space in the bone the drill is stopped when it meets the tip of the drill sleeve