ACL Animation

The video below demonstrates the N8TIVE ACL reconstruction surgical process in the knee.


A tissue graft is removed from the patient, typically a tendon from the hamstring. The graft is prepared with sutures and resized according to the size of the patient’s original ACL.

A pin is placed on the Anteromedial (AM) Bundle footprint on the femur, the site where the ACL used to be attached. This pin is used as a guide to drill two tunnels for the ACL graft, one anteromedial (AM) and one posterolateral (PL). Two tunnels are used to more accurately mimic the anatomy of the native ACL, which has both an AM and PL bundle (illustrated at the end of the video). The tunnels are then resized to fit the ACL graft. A smaller drill is used to make a tunnel for the graft button.

A guide instrument is placed on the tibia to highlight the ACL’s tibial footprint. Pin guides are advanced into the tibia to create the PL and AM tunnels that will house the ACL graft. The tunnels are then drilled and tamped to create an appropriately sized tunnel for the graft.

A suture loop is passed through the femoral tunnel, and a cortical button on the loop is used to keep it in place. The ACL graft is then passed into the femoral tunnel and tamped in place. The free ends of the graft are then passed through the tibial tunnel and pulled to tension. A tibial sheath and screw are placed to lock the graft into position. A cortical button is used to seal the suture loop in place.