A novel technique for bone debris clearance during anterior cruciate ligament reconstruction

Background Anterior cruciate ligament (ACL) reconstruction using hamstring graft or bone-patella-bone graft results in the accumulation of bone debris within the knee joint. This has been identified as a causative factor in post-operative complications, including knee effusion and osteophyte generation. This technical note describes a technique aiming to reduce the accumulation of bone debris within the knee joint following ACL reconstruction. Method Following creation of the femoral tunnel using a retrograde reamer during ACL reconstruction, the reamer is removed and the femoral tunnel guide left in place. In the attempt to reduce the presence of bone debris, a 20 ml syringe of sterile saline is then injected at high pressure through the guide and femoral tunnel from outside to in. Results In our experience, this additional operative step significantly reduced the accumulation of bone debris within the femoral canal during ACL reconstruction. Conclusions We conclude that this simple additional step can reduce bone debris left within the joint during ACL reconstruction.