Anterior cruciate ligament rupture results in knee instability or the premature wear of the menisci, a potential source of early osteoarthritis in young patients. Arthroscopic reconstruction of the anterior cruciate ligament using a short graft of the semitendinosus tendon (4-strand semitendinosus autograft) is a reliable, proven method for stabilising the knee and enabling a return to the same level of sports activity as before. This technique has the advantage of using only one tendon with excellent mechanical strength and very low donor site morbidity.