Anatomic All‐Epiphyseal Anterior Cruciate Ligament Reconstruction With Concomitant Lateral Extra‐articular Tenodesis Using Iliotibial Band Autograft

Anterior cruciate ligament rupture is increasingly common in skeletally immature patients. The Micheli‐Kocher iliotibial band technique is physeal‐sparing, but nonanatomic, whereas all‐epiphyseal reconstructions reproduce the anterior cruciate ligament footprint but lack lateral support. We describe an anatomic all‐epiphyseal anterior cruciate ligament reconstruction using an iliotibial band autograft in which the graft is passed through fluoroscopically confirmed all‐epiphyseal tunnels and fixed with a femoral interference screw and tibial anchor, tensioning the native distal course of the iliotibial band for anterolateral reinforcement. This reproducible technique combines physeal safety and anatomic reconstruction with functional anterolateral reinforcement that may enhance rotational stability.