Combined Anterior Cruciate Ligament and Anterolateral Ligament Reconstruction Using Rectus Femoris Tendon Autograft

Andrea Di Muro; Francesco Pettinari; Enrico Macchiarella; Zyad Ayman Taha; Flavio Azzola; Roberto Civinini; Fabrizio Matassi

doi:10.1016/j.eats.2025.103845

Combined Anterior Cruciate Ligament and Anterolateral Ligament Reconstruction Using Rectus Femoris Tendon Autograft

Arthrosc Tech. 2025 Sep 22;14(11):103845. doi: 10.1016/j.eats.2025.103845. eCollection 2025 Nov.

Authors

Andrea Di Muro¹, Francesco Pettinari¹, Enrico Macchiarella¹, Zyad Ayman Taha¹, Flavio Azzola², Roberto Civinini¹, Fabrizio Matassi¹

Affiliations

¹ Department of Orthopaedics, University Hospital of Florence-AOU Careggi, Florence, Italy.
² Department of Orthopaedics, S. Anna Clinical Institution, Brescia, Italy.

Abstract

Anterior cruciate ligament (ACL) reconstruction is among the most performed orthopaedic surgical procedures. Combining ACL reconstruction with a lateral extra-articular procedure is crucial to improve the graft survival rate, especially in patients presenting with associated rotational instability. Multiple grafts and surgical techniques can be used to perform this combined procedure, each having its own advantages and disadvantages. This technical note describes a minimally invasive technique to perform combined ACL and anterolateral ligament reconstruction using a single autologous continuous graft: the rectus femoris tendon.