Comparison of outcome after anatomic double-bundle and antero-medial portal non-anatomic single-bundle reconstruction in ACL-injured patients View Full Text


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Article Info

DATE

2016-04-22

AUTHORS

Ioannis Karikis, Mattias Ahldén, Abraham Casut, Ninni Sernert, Jüri Kartus

ABSTRACT

PurposeThe aim of this study was to compare anatomic double-bundle anterior cruciate ligament reconstruction with non-anatomic single-bundle reconstruction.MethodsIn a prospective consecutive series, 94 unselected patients [45 anatomic double-bundle (ADB) and 49 non-anatomic single-bundle (SB)] underwent ACL reconstruction involving hamstring tendon autograft, interference screw fixation on both the femoral and tibial side and drilling the femoral tunnel(s) through the antero-medial portal in both groups. In the ADB group, the remnants of the ACL were identified and the grafts were placed anatomically. In the SB group, traditional placement of the graft was performed in a less anatomic manner. Pre-operatively, the groups were comparable in terms of age, gender, time between injury and operation and associated injuries. One independent physiotherapist performed all the pre-operative and post-operative assessments.ResultsThe follow-up period was 26 (22–34) and 24 (23–30) months in the ADB and SB groups, respectively (p = 0.005). At follow-up, 78 % in the ADB group and 74 % in the SB group had a negative pivot-shift test (n.s.). The KT-1000 134N measurements were 2 (−5 to 10.5) and 2 (−4 to 7) mm in the ADB and SB groups, respectively (n.s.). At follow-up, the extension deficit was significantly larger in the ADB group than in the SB group (p = 0.001). The Tegner activity scale was significantly higher in the ADB group both pre-operatively and at follow-up (p = 0.03 and p = 0.004). In overall terms, both groups had improved significantly at the two-year follow-up.ConclusionIn an unselected group of ACL-injured patients, anatomic double-bundle reconstruction did not result in better rotational or antero-posterior stability measurements than antero-medial portal non-anatomic single-bundle reconstruction at the two-year follow-up.Level of evidence III. More... »

PAGES

1307-1315

References to SciGraph publications

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  • 2013-09-15. Is double-bundle anterior cruciate ligament reconstruction superior to single-bundle? A comprehensive systematic review in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
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  • 2012-09-12. Single-bundle versus double-bundle anterior cruciate ligament reconstruction: an up-to-date meta-analysis in INTERNATIONAL ORTHOPAEDICS
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  • Identifiers

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    http://scigraph.springernature.com/pub.10.1007/s00167-016-4132-z

    DOI

    http://dx.doi.org/10.1007/s00167-016-4132-z

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/27106922


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    34 schema:description PurposeThe aim of this study was to compare anatomic double-bundle anterior cruciate ligament reconstruction with non-anatomic single-bundle reconstruction.MethodsIn a prospective consecutive series, 94 unselected patients [45 anatomic double-bundle (ADB) and 49 non-anatomic single-bundle (SB)] underwent ACL reconstruction involving hamstring tendon autograft, interference screw fixation on both the femoral and tibial side and drilling the femoral tunnel(s) through the antero-medial portal in both groups. In the ADB group, the remnants of the ACL were identified and the grafts were placed anatomically. In the SB group, traditional placement of the graft was performed in a less anatomic manner. Pre-operatively, the groups were comparable in terms of age, gender, time between injury and operation and associated injuries. One independent physiotherapist performed all the pre-operative and post-operative assessments.ResultsThe follow-up period was 26 (22–34) and 24 (23–30) months in the ADB and SB groups, respectively (p = 0.005). At follow-up, 78 % in the ADB group and 74 % in the SB group had a negative pivot-shift test (n.s.). The KT-1000 134N measurements were 2 (−5 to 10.5) and 2 (−4 to 7) mm in the ADB and SB groups, respectively (n.s.). At follow-up, the extension deficit was significantly larger in the ADB group than in the SB group (p = 0.001). The Tegner activity scale was significantly higher in the ADB group both pre-operatively and at follow-up (p = 0.03 and p = 0.004). In overall terms, both groups had improved significantly at the two-year follow-up.ConclusionIn an unselected group of ACL-injured patients, anatomic double-bundle reconstruction did not result in better rotational or antero-posterior stability measurements than antero-medial portal non-anatomic single-bundle reconstruction at the two-year follow-up.Level of evidence III.
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