Reconstruction of the anterior cruciate ligament using a double bundle.

We developed a reconstruction technique for the anterior cruciate ligament using a double bundle that is the combination of bone-tendon-bone (BTB) from the patellar tendon and semitendinosus tendon (ST). BTB is fixed in the tunnels produced on the isometric points on the tibia and femur. ST is fixed on the tibial tunnel through the same route as the BTB, but on the femur, through the over-the-top route, which is located posterolateral to the femoral tunnel. Use of this double bundle realizes a physiologically more durable reconstruction because BTB corresponds to the anteromedial bundle of the ACL and ST corresponds to the posterolateral bundle, and these produce 2 different tension patterns within the bundle. This technique is also applicable to revision surgeries for patients with an extended bone loss on the tibia.