Fig 5.

Converting a round tendon to a flat graft. The tendon is fixed on a preparation board and any fatty or muscular tissue is already removed. The round tendon part of the semiT then is dissected by knife to half of its diameter ([A], with a semiT graft; [E], schematic drawing) and subsequently smoothed into flat shape by blunt raspatorium at minimum pressure (B). As Domnick et al.²² showed, this does not affect the structural properties of the tissue. As in usual ACL reconstructions using a semiT, the tendon is folded twice after the flattening, however, still keeping its flat shape. We aim for a length of 6 to 7 cm. (C) View on the wide part of the quadrupled graft; and (D) on the narrow part. (ACL, anterior cruciate ligament.)