Combined Anterior Cruciate Ligament Repair and Anterolateral Ligament Reconstruction With a Single-Strand Gracilis Graft

There has been renewed interest in anterior cruciate ligament (ACL) repair procedures in the past decade. Even though ACL reconstruction is still considered the gold standard, ACL repair is an alternative in selected patients. However, the risk of failure owing to isolated ACL repair remains a concern. Intra-articular augmentation has been proposed to protect the repair during the healing period. In the same way, the protective effect of anterolateral ligament reconstruction on the ACL graft is increasingly recognized. We describe a combined ACL repair and anterolateral ligament reconstruction technique with a single-strand gracilis for the intra-articular portion and as an anterolateral graft to protect the ACL repair during the healing phase.