Figure 1: AP and lateral radiographs of right knee demonstrating previous autograft bone-patellar tendon-bone (BTB) ACL reconstruction with vertical graft placement.
Figure 3: AP and lateral radiographs of right knee showing ACL revision with posterolateral bundle augmentation.
Figure 2.: Right knee MRI showing intact ACL BTB graft. Figure 4: Right knee MRI showing intact PL bundle augmentation at 2 years postop.
Discussion Traditional single-bundle anterior cruciate ligament reconstruction has been shown to achieve good to excellent results in about 60% of patients.6 Fu, et al., have done extensive studies on the concept of anatomic doublebundle anterior cruciate ligament reconstruction.7 The anteromedial bundle (AM) is the main contributor to
anterior-posterior stability, while the posterolateral bundle (PL) mainly controls rotational stability, especially in deep knee flexion. In rare instances, partial ligamentous disruption of one anterior cruciate ligament bundle in the native ligament may occur. Clinical exam may show a low grade pivot shift or glide but few other findings. A high index of suspicion
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