Endoscopic anterior cruciate ligament reconstruction using doubled gracilis and semitendinosus tendons and EndoButton femoral fixation

Donor site complications associated with the use of patellar tendon autografts have resulted in increased interest in the use of multiple-stranded hamstring tendon grafts (semitendinosus and gracilis tendons) for anterior cruciate ligament (ACL) reconstruction. Two major advantages of hamstring tendon grafts are their high initial strength and stiffness, and their harvest results in minimal donor site morbidity. The EndoButton (Smith and Nephew, Andover, MA) provides a quick, simple, strong, and reproducible endoscopic method of securing the femoral end of hamstring tendon grafts. This article describes our technique of endoscopic ACL reconstruction using a doubled semitendinosus and gracilis autograft with EndoButton femoral fixation.