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Current techniques for anterior cruciate ligament (ACL) reconstruction do not completely reproduce the anatomy and function of the ACL. They address only the anteromedial bundle and do not fully restore ACL function throughout the range of motion. Current grafts control anterior tibial subluxation near extension, but are less efficacious in providing rotatory stability. Recently, several authors have suggested reconstructing not just the anteromedial bundle but also the posterolateral bundle. This technical note describes a double-bundle ACL reconstruction using hamstring tendons routed through 2 tibial and 2 femoral independent tunnels.

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When faced with a clinical suspicion of knee ligament injury, MRI nowadays has a central role in the diagnostic strategy. In particular, it is essential for assessing the cruciate ligaments and any associated meniscal tears. The objective of this review is to present the various direct and indirect MRI signs of tearing of the anterior cruciate ligament (ACL) and then describe the lesions associated with it. The anatomical and clinical aspects are also discussed so that the contribution of MRI to the diagnosis and therapeutic management of an ACL tear can be better understood.