Over-the-Loop Technique for Combined Anterior Cruciate Ligament Reconstruction and Modified Lemaire Tenodesis: Enhancing Rotational Stability With a Single Femoral Tunnel.

This article describes a combined technique for anterior cruciate ligament reconstruction and modified anterolateral Lemaire tenodesis using a single femoral tunnel. The approach uses quadrupled hamstring grafts (semitendinosus and gracilis) and an "over-the-loop" passage of the iliotibial band through the graft loop. This technique aims to enhance rotational stability, minimize the risk of tunnel convergence, and reduce technical complexity and associated costs. Biomechanical benefits include improved rotational control, reduced graft rerupture rates, and optimized postoperative rehabilitation. The simplicity and reproducibility of this technique make it an attractive option for orthopaedic surgeons treating high-risk patients or rotational sport athletes.