**9. Anatomic double bundle reconstruction limitations**

If one wish to maintain a sufficient graft size (7mm for AMB and 6mm for PLB), small ACL footprints (less than 14mm long) do not allow drilling independent tunnels with a sufficient bone bridge in between. In this case single bundle reconstruction must be used. Also narrow intercondylar notch is a severe limitation as it does not leave enough space for the graft. The concept of anatomic double bundle ACL reconstruction was further applied to partial tears of the ACL when one bundle only has been ruptured. In these particular cases it has been proposed to reconstruct only the damaged bundle, performing an ACL augmentation (Borbon CA et al., 2011; Serrano-Fernandez JM et al., 2010).
