The presence of remnant tibial and femoral attachments of the ruptured ACL has been described in the literature but the femoral remnant has not been well described as a landmark for tunnel placement during reconstruction. We reviewed operative reports, pictures, and videotapes from 111 ACL reconstructions to determine the incidence of a remnant femoral stump. Patients were divided into two groups: Group A included patients treated from January 2006 through September 2006 (n = 63) when the presence of the femoral footprint was documented retrospectively and Group B included patients treated from September 2006 through June 2007 (n = 48) when the presence or absence of the femoral footprint was documented prospectively. In Group A, there were 48 of 58 (83%) patients with a visible stump and 10 (17%) patients in whom we could not verify the existence of the stump. In Group B, 43 of 44 (98%) patients had a visible stump on the lateral femoral wall that was adequate as a guide for femoral tunnel placement. The native femoral footprint is seen in most cases of ACL reconstruction and can be used for guidance during femoral tunnel preparation.
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