A simple, reliable, arthroscopically-assisted procedure is presented in which a doubled and suture woven semitendinosus and gracilis free tendon graft is used in the anterior or posterior cruciate ligament deficient knee. A ligament guide system is used for isocentric placement of tibial and femoral drill holes. The procedure is performed using a button and staple technique that allows accurate placement of the ligament substitution and facilitates early ambulation. At an average follow-up of 2.5 years, good and excellent results have been demonstrated in 97% of 74 knees in which this technique was used, with only a 3% risk of graft failure.