Arthroscopic Reconstruction of ACL and LCL Tear with Combined Asymmetric Hamstring Graft Using Single Femoral Tunnel - A Case Report

Anterior cruciate ligament (ACL) injury is associated with various degrees of rotational deformity. About 15% have a positive pivot shift test after accurate ACL reconstruction. Unrepaired lateral collateral ligament (LCL) tear can lead to increase load on reconstructed ACL and lead to ligament failure. We present a case of combined ACL with LCL tear treated arthroscopically using a single femoral tunnel and asymmetric combined semitendinosus and gracilis (STG) graft. The patient had full range of motion at the knee joint and was able to squat and sit cross-legged and was able to carry out activities of daily living at 8 months of follow-up. Our technique provides orthopedic surgeons with an alternative for combined ACL and LCL reconstruction with a single combined STG graft, thereby limiting additionally graft site morbidity and avoiding the need for allograft and preserving adequate femoral bone stock by preparing only a single femoral tunnel and thus limiting the cost to the patient using single implant for femur.