Fig 7.

Clinical photographs depicting (A) free flap of periosteum (black asterisk) flipped inside out and being sutured onto the femoral end of the quadrupled STT. (B) Quadrupled STT graft over a fixed loop button with periosteal sleeves on either, Note the location of the periosteal sleeves on the quadrupled graft, which must be positioned at intra-articular margins of the planned femoral and tibial tunnels. White asterisk: Periosteal sleeve attached to STT, which will be at the tibial side of the graft; black asterisk: Free flap of periosteum sutured on to the femoral side of the graft. (STT, semitendinosus tendon.)