Bilateral Anterior Cruciate Ligament Reconstruction Using Gracilis and Semitendinosus Graft by Single-Staged Approach

A bilateral anterior cruciate ligament (ACL) tear is one of the rare injuries that is seen in orthopaedics practice. Although few single-staged bilateral ACL ruptures have also been documented, most bilateral ACL ruptures happen on two different occasions. Although there isn't a clear consensus, there have been accounts of both single-staged and two-staged reconstruction of bilateral ACL ruptures in the literature. This case report provides surgeons with options to consider while treating this unusual injury. A 35-year-old woman with bilateral anterior cruciate ligament injuries presented with an MRI of her left knee suggestive of a complete ACL tear with a Medial meniscus tear in the left knee, and an MRI of her right knee showed a complete ACL tear. The patient underwent arthroscopic ACL reconstruction in a single stage for both knees. Six months after her surgery, she had met all the rehabilitation goals and was cleared to resume her daily activities. The patient preoperatively had a visual analogue scale (VAS) score of 8, and postoperative assessment, her VAS score reduced to 2. ACL reconstruction in one stage and two stages were the surgical treatment modalities described in the literature. Concurrent rehabilitation of both ACL repairs is more economical, reduces hospital stay, and helps in early recovery, but it may result in severe quadriceps deconditioning. Double-staged surgeries are less demanding, with a shorter duration of surgery that can be performed by a less experienced surgeon. As single-staged bilateral ACL reconstruction is a less expensive option that reduces hospital stays and aids in early recovery for this rare patient population, it may be a great therapy option compared to two-staged bilateral ACL reconstruction.