Both free ends of the semitendinosus were stitched over a length of 30 mm, using No. 2 ExpressBraid™ suture (Zimmer Biomet, Warsaw, IN). Two adjustable-length loop cortical button devices were used: ToggleLoc™ (Zimmer Biomet, Warsaw, IN), for the femur, and ToggleLoc XL Inline™ (Zimmer Biomet, Warsaw, IN), for the tibia. The tendon graft was symmetrically folded over the tibial cortical button loop and the doubled graft was passed through the femoral cortical button loop and once again symmetrically folded. Both grafts free ends are tied together with 3 knots over the tibial button loop. Then, the same sutures are tied over the graft itself using 4 knots5 .
Finally, the graft is reinforced to the tibial side with a cerclage suture and a buried knot6 (link).
To simulate the common tunnel lengths on the femur and tibia we assumed a constant femoral side length of 40 mm (including graft’s 15 mm) and a tibial side length of 50 mm (including graft’s 20 mm), adjusting both ToggleLoc™ loops, in order to achieve these values.
Finally, the graft is reinforced to the tibial side with a cerclage suture and a buried knot6 (link).
To simulate the common tunnel lengths on the femur and tibia we assumed a constant femoral side length of 40 mm (including graft’s 15 mm) and a tibial side length of 50 mm (including graft’s 20 mm), adjusting both ToggleLoc™ loops, in order to achieve these values.