How Modern Knee Surgery Rebuilds the ACL

In the past, surgeons fixed the anterior cruciate ligament by putting a tunnel through the shin bone. They used a single bundle and a straight hole. Now they aim to copy the natural shape of the ligament.

The new method uses two bundles, called double‑bundle, and a square‑shaped tunnel that follows the bone’s natural angle. They pull the graft with a gentle, natural tension instead of a tight yank. Keeping the original tissue ends, called remnant preservation, helps the graft stay healthy.

When the meniscus is also hurt, doctors see it as part of the problem, not just a side note. They may add extra‑articular devices on the outside of the knee or do a bone cut that lowers the slope of the shin bone. These steps target leftover rotation and lower the chance of failure.

The overall goal is to rebuild the knee exactly as it was, using each patient’s own anatomy. Tailored plans let the joint move naturally and stay strong for years.