We developed a reconstruction technique for the anterior cruciate ligament
using a double bundle that is the combination of bone-tendon-bone (BTB) fro
m the patellar tendon and semitendinosus tendon (ST). BTB is fixed in the t
unnels produced on the isometric points on the tibia and femur. ST is fixed
on the tibial tunnel through the same route as the BTB, but on the femur,
through the over-the-top route, which is located posterolateral to the femo
ral tunnel. Use of this double bundle realizes a physiologically more durab
le reconstruction because BTB corresponds to the anteromedial bundle of the
ACL and ST corresponds to the posterolateral bundle, and these produce 2 d
ifferent tension patterns within the bundle. This technique is also applica
ble to revision surgeries for patients with an extended bone loss on the ti
bia.