 Knee dislocations often involve injury to multiple major knee ligaments, necessitating concurrent multi-ligament reconstruction to restore native joint stability. One of the most important variables in this procedure is successful graft tensioning, but there's been little consensus as to which tensioning sequence best achieves an anatomic tibioframoral orientation. To guide surgical decision-making, a team based at the Steadman-Philipon Research Institute in Colorado biomechanically tested different graft tensioning sequences on a human model of knee dislocation. Their results revealed one sequence that may improve outcomes from multi-ligament reconstruction. The testing was performed on 10 cadaveric knee specimens. The team mimicked the injuries sustained during a dislocation by subjecting each knee to sectioning of the anterior cruciate ligament, the posterior cruciate ligament, and the static stabilizers of the postural lateral corner. The sectioned knee was then placed in a custom-made robotic fixture for ligament reconstruction. Using reconstruction grafts, the team performed a double bundle PCL reconstruction, an ACL reconstruction, and a double graft reconstruction of the three main static stabilizing structures in the postural lateral corner of the knee. During the procedure, each graft was tightened in one of four separate tensioning sequences. Kinematic testing was performed after each sequence. This involved placing the knee at 0, 30, 60, and 90 degrees of flexion to assess the newly obtained tibioframoral orientation after reconstruction. The orientation was identified using predefined landmarks, which were also obtained in the intact state. The results showed that none of the sequences restored native tibioframoral orientation, but one sequence did appear to outperform the others. The team found that first tightening the grafts for the double bundle PCL reconstruction, followed by the ACL reconstruction graft, and then the postural lateral corner reconstruction grafts gave the best chance at avoiding abnormal kinematics and positioning of the knee. Although the researchers didn't test all possible tensioning orders, these findings provide the first empirically tested answer regarding which grafts to tension first during a multi-ligament reconstruction of a dislocated knee. By identifying the sequence, most likely to produce a favorable orientation, they've taken the field one step closer to preserving joint function.