Combined Anterior Cruciate Ligament and Anterolateral Ligament Reconstruction Using a Rectus Femoris Graft With Anterior Cruciate Ligament-Adjustable Cortical Suspensory Fixation and Single Femoral Tunnel.

Anterior cruciate ligament (ACL) and anterolateral ligament (ALL) injuries frequently coexist and contribute to residual rotational instability after isolated ACL reconstruction. Although several combined reconstruction techniques using hamstring or patellar tendons have been described, they often involve multiple tunnels and complex graft preparation. This Technical Note presents a reproducible technique for combined ACL and ALL reconstruction using a single rectus femoris tendon autograft prepared in GraftLink configuration. The graft is secured with ACL TightRope II suspensory fixation using a single femoral tunnel for both ligaments. This approach offers strong graft integrity, minimizes tunnel convergence, and is applicable in both primary and revision surgeries.