Intra- and extra-articular hamstring reconstruction of anterior cruciate ligament tears

We examined a reconstruction technique for tears of the anterior cruciate ligament using the hamstring tendons. The tendons were harvested en bloc, leaving the tibial insertion intact. Three intra-articular strands (two semitendinous and one gracilis) and lateral tenodesis were used with continuity via the gracilis. The intra-articular procedure was performed arthroscopically with tunneling laterally to medially to achieve the best position. Ligamentoplasty was performed in 262 cases. Outcome was satisfactory. This method preserves the lateral iliotibial sheath and spares the extensors apparatus. It is particularly interesting for reconstruction of anterior cruciate ligament tears when a lateral tenodesis appears to be necessary.