title: Posterior Wall Blowout in Anterior Cruciate Ligament Reconstruction: A Review of Anatomic and Surgical Considerations.
abstract: Violation of the posterior femoral cortex, commonly referred to as posterior wall blowout, can be a devastating intraoperative complication in anterior cruciate ligament (ACL) reconstruction and lead to loss of graft fixation or early graft failure. If cortical blowout occurs despite careful planning and adherence to proper surgical technique, a thorough knowledge of the anatomy and alternative fixation techniques is imperative to ensure optimal patient outcomes. This article highlights anatomic considerations for femoral tunnel placement in ACL reconstruction and techniques for avoidance and salvage of a posterior wall blowout.
authors.affiliation: The Steadman Clinic, Vail, Colorado, USA.; Steadman Philippon Research Institute, Vail, Colorado, USA.
authors.forename: Justin J
authors.initials: JJ
authors.lastname: Mitchell
authors.affiliation: Steadman Philippon Research Institute, Vail, Colorado, USA.
authors.forename: Chase S
authors.initials: CS
authors.lastname: Dean
authors.affiliation: Steadman Philippon Research Institute, Vail, Colorado, USA.
authors.forename: Jorge
authors.initials: J
authors.lastname: Chahla
authors.affiliation: The Steadman Clinic, Vail, Colorado, USA.; Steadman Philippon Research Institute, Vail, Colorado, USA.
authors.forename: Travis J
authors.initials: TJ
authors.lastname: Menge
authors.affiliation: The Steadman Clinic, Vail, Colorado, USA.
authors.forename: Tyler R
authors.initials: TR
authors.lastname: Cram
authors.affiliation: The Steadman Clinic, Vail, Colorado, USA.; Steadman Philippon Research Institute, Vail, Colorado, USA.
authors.forename: Robert F
authors.initials: RF
authors.lastname: LaPrade
keywords: ACL; ACL reconstruction; complications; ligament; tunnel placement