Arthroscopic Anterior Cruciate Ligament Reconstruction Using Iliotibial Band Autograft With Bone Block

Anterior cruciate ligament (ACL) reconstruction is the first‐line treatment for ACL injury, whereas existing autologous grafts each have inherent limitations. This study describes the use of an iliotibial band (ITB) graft with a bone block for ACL reconstruction, designed as a femoral bone block combined with tibial tendon configuration, which precisely matches the anatomical attachment and biomechanical loading characteristics of the native ACL. The surgery is performed through arthroscopic evaluation, harvesting and weaving of the ITB with a bone block, creation of femoral and tibial bone tunnels, and graft introduction and fixation. This graft features the advantage of easy harvesting of the ITB, whereas the femoral bone column allows for rapid bone‐to‐bone healing, enhances stability within the femoral tunnel, and reduces the risk of tunnel widening and femoral‐sided rerupture. Tibial‐sided tendon fixation avoids excessive tibial tunnel enlargement and simplifies surgical steps. Arthroscopic ACL reconstruction using the ITB with bone block is technically straightforward and provides high initial stability. It offers another graft option for both primary treatment of ACL injury and revision surgery after failed reconstructions and is particularly suitable for patients with multiple previous tendon harvests from the same knee or those requiring large‐diameter grafts because of bone tunnel enlargement.