Continuous Bone–Quadriceps Tendon–Rectus Femoris Autograft for Revision Anterior Cruciate Ligament and Anterolateral Ligament Reconstructions

Revision anterior cruciate ligament (ACL) reconstruction is a frequent procedure due to the significant incidence of rupture following primary reconstruction. Achieving strong graft fixation alongside favorable biological conditions is essential for optimal graft healing, which can present challenges in the context of revision surgery. Additionally, the addition of anterolateral ligament reconstruction is recommended during revision procedures, necessitating adequate graft length or the use of a secondary harvest site. Consequently, the selection of an appropriate autograft for revision ACL reconstruction is critical to satisfy these requirements. Recently, the rectus femoris tendon and its aponeurosis have been proposed as viable autograft options for ACL reconstruction. Herein, we describe the surgical technique for combined ACL and anterolateral ligament reconstruction using a continuous autograft composed of a patellar bone block, partial-thickness quadriceps tendon, and the rectus femoris tendon and aponeurosis.