Functional evaluation of the double-bundle vs single-bundle anterior cruciate ligament ligamentoplasty. Prospective com-parative study.

Abstract

Background: The anatomical reconstruction of the anterior cruciate ligament is of great interest because its function is directly related to its anatomy. The aim of the study was to compare dou-ble-bundle with single-bundle ligamentoplasty of the anterior cruciate ligament using a biome-chanical analysis of gait and balance. Methods: Prospective comparative experimental clinical study on 64 people, 27 health subjects and 37 patients with anterior cruciate ligament injury. 19 injured subjects were assigned to single-bundle and 18 to double-bundle technique. Gait biomechanical analysis in all individuals were performed by means of four test and injured subjects ones were repeated at 3, 6 and 12 months after surgery: 1) kinematic test, to characterize gait pattern; 2) kinetic test, to characterize forces against floor, du-ration of treads, symmetry of both legs, and the reproducibility of the gait; 3) pivot-shift gait test, to analyze the rotational stability of the knee in the sagittal axis; and 4) equilibrium test. Results: The two surgical techniques achieved an improvement of the functional alteration (gait pattern, changes in the forces against floor, duration of treads, symmetry of both legs, and the re-producibility of the gait, and changes in bipedal standing equilibrium), with little differences be-tween the two techniques, with neither being superior to the other. Conclusion: Reconstruction of the anterior cruciate ligament with the double-bundle technique offered very similar improvement in functional recovery than the single-bundle technique. At 12-months after surgery, double-bundle technique did not result in better rotational stability of the knee.