Table 1.

Advantages of Technique

Combined reconstruction

No need for second operation as in staged reconstruction

Saves time of patient

Lower risk of ACL graft failure

No negligence of MCL reconstruction

POL reconstruction

Reconstruction of both MCL and POL

Nearly anatomic reconstruction of MCL

POL plays key role in limiting internal rotation with knee in full extension10https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5796970/11

Graft choice

Avoids allograft comorbidities, less cost, more incorporation

Avoids risk of fracture of patella, early rehabilitation

Preserves ipsilateral semitendinosus, no more weakening of medial side of knee

Anatomic graft position and graft shape

Graft suspension

Adequate graft length for MCL and POL reconstruction

More graft fixation by graft anchorage at distal end of ACL tibial tunnel

Single tibial tunnel

One interference screw is used for fixation of both ACL and MCL grafts at tibial tunnel

Little morbidity to patient and with less cost

Minimizes number of tibial tunnels

Avoids tunnel collision and transection in medial tibial cortex

Avoids graft rupture and weakening or fracture of medial tibial cortex

Preserves bone stock at medial tibial cortex

ACL, anterior cruciate ligament; MCL, medial collateral ligament; POL, posterior oblique ligament.