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This single\u2010stage procedure involves ACL reconstruction using a quadriceps tendon autograft combined with minimally invasive MCL augmentation using a pedicled gracilis tendon with preserved distal attachment. This gracilis\u2010based approach addresses both superficial MCL and deep MCL stabilization in cases with valgus laxity at 20\u00b0 to 30\u00b0 of knee flexion. The present article outlines graft harvest, tunnel placement, graft routing, and fixation, emphasizing isometric reconstruction and graft protection. This combined procedure is believed to restore native knee biomechanics and to reduce ACL graft failure risk.<\/jats:p>","DOI":"10.1002\/atn2.70097","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T10:52:21Z","timestamp":1779274341000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Anterior Cruciate Ligament Reconstruction and Medial Collateral Ligament Augmentation With Pedicled Gracilis Tendon to Address Anteromedial Rotatory and Valgus Instability"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1574-4157","authenticated-orcid":false,"given":"Lukas","family":"Willinger","sequence":"first","affiliation":[{"name":"Department of Sports Orthopaedics TUM University Hospital, Technical University of Munich  Munich 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