Technical note: Anterior cruciate ligament reconstruction in the presence of an intramedullary femoral nail using anteromedial drilling

Table 1 Preoperative planning for anterior cruciate ligament reconstruction with distal femoral hardware

Obtain and review radiographic studies including computed tomography scan of distal femur to determine location of hardware which may interfere with femoral tunnel placement

Discuss feasibility and necessity of hardware removal, considering location of individual components and entire construct relative to planned femoral tunnel site, with primary surgeon or consulting trauma surgeon

Arrange for proper instrumentation, fluoroscopy and personnel for removal of hardware

Arrange for access to allograft in case hamstring autograft is insufficient in diameter