Anatomic Double-Bundle Transtibial Anterior Cruciate Ligament Reconstruction

Double-bundle anterior cruciate ligament (ACL) reconstruction (DBACLR) is a reasonable transition from single-bundle ACL reconstruction to obtain better clinical outcomes, and most authors believe that it can only be performed through a medial portal. However, in our clinical practice, we have found that anatomic DBACLR can be performed easily and exactly through transtibial tunnels just by positioning the tibial tunnels appropriately. Thus, we would like to introduce this anatomic double-bundle transtibial ACL reconstruction technique, in which the most critical step is to create a shallow tibial tunnel for the anteromedial bundle with a proximal projection to the anatomic location of the corresponding femoral tunnel. We believe this Technical Note will give an interesting view of anatomic DBACLR.