Combined Reconstruction of the Anterior Cruciate Ligament and Anterolateral Ligament by Removing the Semitendinosus and Gracilis: A Simple, Reproducible Technique.

Coulet, Pierre-Louis; André, Guillaume · Arthrosc Tech · 2025

case_series · Level IV

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Abstract

Persistent rotatory laxity is a factor in failure after anterior cruciate ligament (ACL) reconstruction, and numerous studies have highlighted the benefits of ACL reconstruction combined with anterolateral ligament (ALL) reconstruction, in particular to reduce the risk of iterative rupture and provide additional rotatory stability. Various techniques for combined ACL-ALL reconstruction exist, none of which has been proven to be superior. We propose a surgical technique for combined ACL-ALL reconstruction using the hamstrings, pedicled semitendinosus, and gracilis, with a single femoral tunnel.