Methods and systems to optimize ligament reconstruction surgical outcomes by enabling bone tunnel(s) to be precisely and optimally placed through the use of pre-operative planning systems coupled with precision control bone evacuation machines, such as robotic drills are provided. The methods generally include receiving and processing scan data of a patients bone(s) pre-determining the optimal tunnel placement parameter(s) with the scan data placing registration marker(s) on the patients bone(s) percutaneously and creating a tunnel in the patients bone(s) with a system coupled to receive and execute according to the pre-determined optimal tunnel placement parameter(s).
