Speakers - 2026

Restoration of anterior and rotational knee stability remains a major challenge in anterior cruciate ligament (ACL) reconstruction, particularly in physically active patients. Double- bundle ACL reconstruction improves knee kinematics, while additional anterolateral stabilization has been shown to reduce rotational instability. However, many existing techniques rely on hamstring tendon harvesting, potentially compromising important dynamic stabilizers of the knee.

This presentation introduces a novel ACL reconstruction technique that combines double- bundle reconstruction, anterolateral stabilization, and a modified quadriceps tendon graft while preserving hamstring integrity. The technique is based on harvesting a quadriceps tendon graft with a bone block and an extended superficial tendon portion using a minimally invasive approach. The graft is prepared to create two functional bundles suitable for double-bundle reconstruction.

A single tibial tunnel is created, and the bone block is fixed with an interference screw. On the femoral side, two independent tunnels are drilled for the anteromedial and posterolateral bundles. The anteromedial bundle is fixed using a cortical suspension device. The posterolateral bundle is passed transosseously, fixed with an interference screw, and its free end is routed along the lateral aspect of the knee toward Gerdy’s tubercle, where it is fixed to the tibia, providing additional anterolateral stabilization.

This technique preserves all hamstring tendons, maintaining muscle balance and ACL synergists. The combined approach enhances both anterior and rotational stability while minimizing donor-site morbidity.

What will the audience take away from presentation:

• A step-by-step description of a novel ACL reconstruction technique
• Understanding graft preparation for double-bundle reconstruction
• Practical integration of anterolateral stabilization
• Advantages of hamstring preservation
• Surgeons can incorporate this technique into clinical practice as an alternative ACL reconstruction strategy, especially for active patients requiring enhanced stability.
• The technique provides a practical, reproducible solution that improves knee stability while preserving important muscle groups, potentially improving functional outcomes and return-to-sport rates