Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction Using Tibialis Anterior Tendon Allografts

The anterior cruciate ligament (ACL) is a complex structure consisting of 2 functionally independent anatomic bundles, the anteromedial and posterolateral bundles. Anatomic and biomechanical studies have demonstrated distinctive functions for each of these bundles at various degrees of flexion. ACL reconstructions have traditionally focused solely on the reconstruction of the anteromedial bundle, with little consideration for the posterolateral bundle. Recent reports have appeared describing various techniques for anatomic ACL reconstruction in an attempt to recreate the native anatomy. We present an arthroscopic technique of anatomic, double-bundle ACL reconstruction using tibialis anterior tendon allografts. This technique restores the anatomic footprint of the native ACL on both the tibia and the femur. We believe that focusing reconstructive techniques on recreating both bundles of the ACL more closely recreates the biomechanical function of the native ligament.