Arthroscopic Continuous Anterior Cruciate Ligament-Medial Collateral Ligament Reconstruction Using a Single Rectus Femoris Autograft With Posterior Oblique Ligament Reconstruction: A Technical Note.

Multiligament knee injuries are challenging to manage and often require harvesting multiple grafts. Rectus femoris tendon autograft provides predictable length and diameter, making it a promising option for anterior cruciate ligament (ACL) reconstruction and combined procedures. In this technical note, we describe an arthroscopic technique for combined reconstruction of the ACL and medial-sided structure-the medial collateral ligament (MCL) and posterior oblique ligament-in the setting of acute ACL, MCL and posterior oblique ligament rupture. A single rectus femoris autograft is used to reconstruct both ACL and MCL in a continuous fashion, whereas an allograft is used for posterior oblique ligament reconstruction. This technique offers an efficient graft construct for combined ACL and MCL reconstruction, minimizes the need for multiple autograft harvests, preserves the hamstring tendons, and reduces the risk of tunnel convergence.