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An arthroscopic\u2010assisted technique using patella tendon as graft material was performed in all cases. To establish femoral tunnels, a transtibial guide pin was used. The graft was secured with bioabsorbable screws. A Frik tunnel view and a strictly lateral radiograph were used to assess tunnel placements. Tunnel positioning was assessed using a computer\u2010aided design, 2D software (Auto CAD2000<jats:sup>\u00ae<\/jats:sup>). To minimize measurement bias, radiographs were assessed three times or until deviations in all three measurements were less than 10%, and the three measurements were then averaged. Sagittal femoral tunnel placement improved significantly (<jats:italic>P<\/jats:italic> = 0.01) after the first 100 cases. Significant improvement (<jats:italic>P<\/jats:italic> = 0.05) in coronal femoral tunnel placement was observed after the first 75 cases. Significant improvement (<jats:italic>P<\/jats:italic> = 0.01) in sagittal tibial tunnel position was observed after the first 100 cases. Mean coronal tibial tunnel did not improve. Critical analysis in this consecutive series suggests that a caseload of approximately 100 procedures were necessary for this surgeon to refine his surgical technique beyond that acquired during formal training.<\/jats:p>","DOI":"10.1007\/s00167-010-1183-4","type":"journal-article","created":{"date-parts":[[2010,6,18]],"date-time":"2010-06-18T11:44:15Z","timestamp":1276861455000},"page":"1576-1582","source":"Crossref","is-referenced-by-count":26,"title":["Tunnel positioning in anterior cruciate ligament reconstruction: how long is the learning curve?"],"prefix":"10.1002","volume":"18","author":[{"given":"Erik","family":"Hohmann","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Clinical Medical School University of Queensland Brisbane QLD Australia"},{"name":"Musculoskeletal Research Unit CQ University PO Box 4045 4700 Rockhampton QLD 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