Table 1.

Advantages of the Technique

Advantages
Combined reconstruction 1. No need for second operation as in staged reconstruction 2. Save time of busy patients 3. No negligence of PLC reconstruction 4. Reconstruction of FCL, PLT, and PFL 5. No fear of ACL graft failure
Outside-in technique 1. Allow a clear visualization in 90° knee flexion 2. No need for 120° knee flexion 3. No need for special instruments (e.g., flexible instruments) 4. Better coverage of the femoral ACL foot print 5. Avoids soft tissue injury (e.g., medial femoral condyle) during femoral guide pin insertion 6. Easy screw fixation and no fear of loss or breakage of the screw inside the joint 7. No fear of screw wrapping around the graft
Graft suspension 1. FCL, PLT, and PFL are reconstructed with a graft of adequate length and width 2. Add more fixation to the graft by graft anchorage at the cortex of the lateral femoral condyle
Single femoral tunnel 1. One interference is used for fixation of both ACL and PLC grafts at the femoral tunnel 2. Little morbidity to the patient and with little cost 3. Minimizes the number of femoral tunnels 4. Avoids tunnel collision and transection in the lateral femoral condyle 5. Avoids graft rupture and weakening or fracture of the lateral femoral condyle

ACL, anterior cruciate ligament; FCL, fibular collateral ligament; PFL, popliteofibular ligament; PLC, posterolateral corner; PLT, popliteus tendon.