Combined Anterior Cruciate Ligament Reconstruction With Bone-Patellar Tendon-Bone Autograft and Anatomical Lateral Collateral Ligament and Proximal Tibiofibular Joint Reconstruction Using Semitendinosus Allograft.

Froom, Ryan J; Panos, Alexi J; Dickinson, Nate J; Kessenich, Molly E; Provencher, Matthew T · Arthrosc Tech · 2026

Level V

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Abstract

Multiligamentous knee injuries involving anterior cruciate ligament rupture and lateral-sided instability, including proximal tibiofibular joint instability and lateral collateral ligament deficiency, present unique challenges in restoring knee stability. This Technical Note describes a reproducible surgical technique for anatomic reconstruction of the anterior cruciate ligament using a bone-patellar tendon-bone autograft and combined lateral collateral ligament and proximal tibiofibular joint reconstruction using a single semitendinosus allograft. Emphasis is placed on proper graft orientation, tunnel placement, and sequential fixation to restore stability in both anterior-posterior and medial-lateral planes of the knee.