Anatomically Oriented Anterior Cruciate Ligament Reconstruction with a Bone-Patellar Tendon-Bone Graft via Rectangular Socket and Tunnel: A Snug-fit and Impingement-Free Grafting Technique

An anterior cruciate ligament (ACL) reconstruction technique is described to place bone-patellar tendon-bone (BPTB) graft in an anatomically oriented fashion to mimic the 2 bundles of the normal ACL, based on the concept of twin tunnel ACL reconstruction, to maximize the graft-tunnel interface. In this technique, the attached bone plug is introduced into a rectangular femoral socket via a halfway rectangular tibial tunnel for the anterior portion of the graft to function as the anteromedial bundle and for its posterior portion to behave as the posterolateral bundle. A snug fitting of the graft is achieved not only at the femoral socket, but also in the tibial tunnel.