Fig 1.

Medial surgical exposure of left knee (with patient supine and knee flexed 30°). (A) The skin incision is made 1 cm above the adductor tubercle and 6 cm below the joint line. (B) The surgeon identifies the medial femoral epicondyle (yellow arrow), joint line (white dashed line), and semitendinosus insertion (white arrow). (C) The surgeon inserts 1 Kirschner wire at the center of the medial femoral epicondyle (yellow arrow) and another in the joint (white arrow). (D) The gracilis tendon is harvested, prepared, and suspended on the anterior cruciate ligament graft to be used as the medial collateral ligament–posterior oblique ligament graft.