Mechanical evaluation of tibial fixation of the hamstring tendon in anterior cruciate ligament double-bundle reconstruction with and without interference screws

Anterior Cruciate Ligament and Anterolateral Ligament Reconstruction With Pedicular Hamstrings Tendon Graft, Single-Strand Gracilis for ALL and Single Blind Femoral Tunnel

“…Preservation of the tibial insertion of hamstrings in isolated ACL reconstruction provide better graft incorporation by supplying vascularization 29 , 30 , 36 and better tibial fixation by native and mechanical fixation. 37 , 38 In combined ACL+ALL reconstruction, only a few authors keep the semitendinous attached, 20 , 23 but the gracilis is always detached. We believe that preserving the tibial insertion of both hamstrings could enhance the incorporation of both grafts, ACL and ALL, in the same way as in isolated ACL reconstruction.…”