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Anterior Cruciate Ligament With Anterolateral Ligament Reconstruction Using Hamstring Autograft With Preserved Distal
Mohammed Aquib Shakeel1, Vadhiraj Krishna Janardhan Balla1, Rakshith A G1
1Division of Arthroscopy, Sports Injury, Joint Preservation & Regenerative Medicine, St. Johns Medical College and Hospital, Bengaluru, India.
Arthroscopy Techniques
|January 16, 2026
Summary
This study presents a technique for reconstructing the anterior cruciate ligament (ACL) and anterolateral ligament (ALL) simultaneously. This approach aims to improve rotational stability after knee surgery by addressing both crucial knee ligaments.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Knee Biomechanics
Background:
- Anterior cruciate ligament (ACL) reconstruction advances still result in postoperative rotational instability.
- The anterolateral ligament (ALL) is increasingly recognized for its role in stabilizing against anterolateral tibial rotation.
- Existing ALL reconstruction techniques vary, highlighting the need for standardized, effective methods.
Purpose of the Study:
- To describe a simple, anatomic technique for combined ACL and ALL reconstruction.
- To utilize hamstring tendon autograft while preserving native tibial insertions.
- To provide a reproducible surgical solution for rotational knee instability.
Main Methods:
- Detailed description of a novel surgical technique for simultaneous ACL and ALL reconstruction.
- Use of hamstring tendon autograft for both ligament reconstructions.
- Emphasis on preserving the semitendinosus and gracilis insertion on the tibia.
Main Results:
- The described technique allows for anatomic reconstruction of both the ACL and ALL.
- Preservation of hamstring tendon insertions aims to maintain dynamic knee stability.
- Initial clinical results suggest this combined approach is effective in addressing rotational instability.
Conclusions:
- This technique offers a straightforward, anatomic method for combined ACL and ALL reconstruction.
- Simultaneous reconstruction may improve rotational control and patient outcomes post-ACL surgery.
- Further clinical studies are warranted to validate long-term efficacy and benefits.
