Simultaneous Bilateral ACL Reconstruction Using a Combination of Autograft and Allograft Tissues: A Technical Note

Purpose To describe a one-stage bilateral anterior cruciate ligament (ACL) reconstruction technique using a combination of autograft and allograft tissues, highlighting its technical considerations and clinical outcomes. Methods A 31-year-old male with bilateral ACL and medial meniscus tears underwent simultaneous reconstruction performed by two surgical teams. A mixed graft configuration was used, combining semitendinosus and rectus femoris autografts with corresponding allografts to create two four-strand constructs. Results The procedure was completed efficiently without complications. Postoperative patient-reported outcome measures showed substantial improvement: IKDC increased from 24.1% to 90.8%, Lysholm from 6 to 92, and KOOS subscales demonstrated parallel gains, particularly in pain and daily activities. Conclusions Simultaneous bilateral ACL reconstruction using a mixed autograft–allograft configuration is a safe and effective option for selected patients. This approach provides excellent functional outcomes while minimizing donor-site morbidity and overall rehabilitation time.