Recessed Femoral Interference Screws in Anterior Cruciate Ligament Reconstruction

There are multiple modes of femoral fixation for the treatment of the anterior cruciate ligament (ACL)–deficient knee. Femoral interference screws are commonly used and are often buried to accommodate a graft–tunnel mismatch. After performing ACL reconstructions and imaging the ACL in 3 cadaveric knee specimens, obvious graft excursion and impingement was seen with recessed femoral interference screw fixation. The consequences of impingement are well known, and when faced with a graft–tunnel mismatch, alternative modes of fixation are advised.