Combined Anterior Cruciate Ligament and Lateral Collateral Ligament Reconstruction

Lateral collateral ligament (LCL) injuries are commonly associated with other knee ligament injuries such as anterior cruciate ligament (ACL) injuries. Significant injuries to the LCL should be addressed at the same time as ACL reconstruction. This prevents any varus instability, which can jeopardize the integrity of the ACL graft, resulting in graft failure. This technical note describes combined ACL and LCL reconstruction using an outside-in drilling technique for the femoral tunnel in which the hamstring tendons are used for simultaneous reconstruction of both injured ligaments, which avoids tunnel convergence.