Combined Anterior Cruciate Ligament and Posterolateral Corner Reconstruction With a Single Femoral Tunnel Using Rectus Femoris and Semitendinosus Autografts

Abstract We describe a reproducible, anatomically based technique for combined anterior cruciate ligament (ACL) and posterolateral corner reconstruction using a single femoral tunnel and 2 autografts: rectus femoris and semitendinosus. Part of the rectus femoris and semitendinosus grafts is prepared for anatomic ACL reconstruction, and a shared femoral tunnel accommodates the ACL femoral socket while providing a lateral exit for proximal posterolateral corner fixation. The remaining rectus femoris graft exiting the femoral tunnel is used to reconstruct the popliteus tendon, and the remaining semitendinosus graft is used to reconstruct the fibular collateral ligament and popliteofibular ligament. This approach enables combined ACL and posterolateral corner reconstruction through a single femoral tunnel, preserving anatomic principles and minimizing the risk of tunnel convergence.