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Related Experiment Video

Updated: Jun 21, 2026

Harvesting of Peroneus Longus Tendon Autograft
04:03

Harvesting of Peroneus Longus Tendon Autograft

Published on: September 2, 2025

Anatomic double-bundle ACL reconstruction using a bone-patellar tendon-bone autograft: a technical note.

Nicolas Pujol1, Olivier Fong, Matthieu Karoubi

  • 1Orthopedic Department, Hôpital André Mignot, 177, rue de Versailles, 78157 Le Chesnay, France. nicolaspujol1@yahoo.fr

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA
|July 9, 2009
PubMed
Summary

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This study details a novel arthroscopic double-bundle anterior cruciate ligament (ACL) reconstruction. The technique utilizes a bone-patellar tendon-bone autograft for improved knee stability.

Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Biomechanical Engineering

Background:

  • Anterior cruciate ligament (ACL) injuries are common, often requiring surgical reconstruction.
  • Double-bundle ACL reconstruction aims to restore native knee biomechanics more effectively than single-bundle techniques.
  • Arthroscopic techniques offer minimally invasive approaches with potential benefits for patient recovery.

Purpose of the Study:

  • To describe an original arthroscopic double-bundle ACL reconstruction technique.
  • To detail the specific methods for graft harvesting, tunnel creation, and fixation.
  • To provide a reproducible surgical technique for orthopedic surgeons.

Main Methods:

  • Arthroscopic double-bundle ACL reconstruction using a bone-patellar tendon-bone autograft.

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  • Harvesting of a rectangular patellar bone block with a double-strand patellar tendon and double tibial bone block.
  • Femoral anteromedial (AM) tunnel created via all-inside technique; femoral posterolateral (PL) tunnel via outside-in technique with 30° divergence.
  • Single tibial tunnel; separate tensioning and fixation of bundles with bioabsorbable interference screws.
  • Specific fixation techniques for AM, PL, and tibial bone blocks at varying knee flexion angles.

    • Main Results:

    • The described technique allows for anatomical reconstruction of both ACL bundles.
    • Separate tensioning and fixation of the graft bundles aim to restore rotational control and stability.
    • The use of bioabsorbable interference screws provides secure fixation while allowing for graft incorporation.

    Conclusions:

    • This arthroscopic double-bundle ACL reconstruction technique offers a viable method for restoring knee function.
    • The described surgical steps provide a reproducible approach for achieving anatomical graft placement and fixation.
    • Further studies are warranted to evaluate the long-term clinical outcomes and biomechanical performance of this technique.