Simultaneous multiple anterior cruciate ligament reconstructions using a single Achilles tendon allograft

This study aimed to evaluate simultaneous multiple anterior cruciate ligament (ACL) reconstructions performed with a single Achilles allograft. After selection of an Achilles allograft with suitable length, the circumference of the isthmus and length of the tendinous portion were measured. The Achilles tendon was divided along its fibers into two or three strips and each strip was looped into a two-strand construct. Fifteen Achilles allografts were used for 31 ACL reconstructions in 30 subjects. The median circumference at the isthmus was 29 mm and the median length of the Achilles tendon 185 mm before and 206 mm after removal of the insertional bone block. The median difference in length before and after removal of the bone block was 19 mm. Achilles allografts with proper length consistently yielded two free tendon grafts suitable for simultaneous multiple ACL reconstruction with good short-term results.