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Chapter 6126consensus on femoral tunnel position within a group of direct colleagues. Furthermore, this consensus is transferred to the orthopedic residents during their training. A multicenter and possibly even a multinational study would be needed to determine if this is indeed the case. Conclusion The aim of this study was to determine the intra- and interobserver reliability of identifying the femoral footprint of the anterior cruciate ligament on MRI. Excellent intraobserver agreement was demonstrated. The interobserver reliability was less compared to the intraobserver reliability. Orthopedic surgeons had a higher level of intra- and interobserver agreement compared to MSK fellowship trained radiologists and, to a lesser extent, to residents in orthopedic surgery. Employing this feature, experienced orthopedic surgeons are the preferred physicians to preoperatively plan femoral tunnel positioning in patient specific ACL reconstruction. By doing so, femoral tunnel malposition may become less of a problem in ACL reconstruction, increasing return to play rates and decreasing re-rupture rates following ACL reconstruction.AcknowledgementsThe authors would like to thank dr. R.E. Stewart for aiding in the statistical analysis, as well as all the observers for participation in the study.Mark Zee.indd 126 03-01-2024 08:56