Fig 7.

Graft preparation. (A) The Achilles graft is prepared for the anterior cruciate ligament and anterolateral ligament reconstruction. The bone block (I) is carved conically to act as a plug to facilitate tibial fixation without implants. The soft tissues are shaped cylindrically (II); we attempt to obtain a diameter of approximately 10 mm. The distal end of the graft is slightly narrower (III) to facilitate the passage of the reconstruction. Sutures (IV) are attached for graft passage. (B) Preparation of the Achilles graft is performed on a separate surgical table. We use Achilles tendon with a bone block that is carved conically (I). Excess material is trimmed (II), and the graft is shaped cylindrically. Finally, sutures are passed and secured to the reconstruction.