App-Based Analysis of Fluoroscopic Images According to Bernard-Hertel Method for the Determination of Femoral Tunnel Positioning in Anterior Cruciate Ligament Reconstruction.

The accurate positioning of the femoral tunnel is crucial for the success of anterior cruciate ligament reconstruction. Malpositioning of the tunnel is believed to be one of the most important reasons for graft failure. While use of anatomic landmarks and industry-supplied aiming devices aid the surgeon in placing the drill pin in the correct position, fluoroscopic imaging is an additional tool used intraoperatively to verify pin placement.