Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction Using Tibialis Anterior Allograft

Single-bundle anterior cruciate ligament (ACL) reconstruction is the current gold standard for the treatment of ACL deficiency. Despite success rates that approach 80% to 90% good-to-excellent results, a significant subset of patients continue to report residual symptoms of instability. Anatomical studies have consistently documented the presence of 2 bundles of the ACL (anteromedial and posterolateral), and recent biomechanical data have supported the theory that an anatomic reconstruction of the ACL may provide a more predictable restoration of normal knee kinematics. A surgical technique for double-bundle ACL reconstruction as well as a postoperative rehabilitation protocol are outlined in this article. The senior author's 2-year results are also given, demonstrating excellent clinical outcomes in nearly all patients.