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this is James Lubitz from Taos New Mexico USA all inside ACL using graphing technique is simple and reproducible but requires meticulous preparation of the graft construct which we are going to demonstrate today now what were going to do is go ahead and pass it first on the tibia side then when we come back the tibia might be a little smaller which is anatomic well keep this tightened down all the way right there and in order once you get these even your assistant will pinch it right here please so they stay even and now Im going to pass it on the femoral side and we bring one in one direction and the other limb in the other direction so that now you see them and have a shorter and quadrupled graft and you can see how its coming through and now what Im going to do is actually pass one of the limbs through the loop so theyre on the same side you can hold these with an ALICE clamp or with a hemostat but eventually those get in the way so the best trick is to take a fiber loop and
