Soft-Tissue Reconstruction of the Anterior Cruciate Ligament With the AperFix System

The anterior cruciate ligament (ACL) is composed of 2 bundles: the anteromedial bundle and the posterolateral bundle. Although conventional transtibial ACL reconstruction recreates only the anteromedial bundle, recent data have shown that this may not restore normal knee kinematics. There has been a recent trend for some authors to recommend double-bundle reconstruction. We describe a technique using a unique new implant to reconstruct the ACL that provides for aperture fixation at both the femoral and tibial sides, and offers the surgeon the flexibility to perform either a conventional quadruple bundle soft-tissue reconstruction, or a single-tunnel, double-bundle reconstruction.