Abstract
Abstract
Subject
This study compared clinical outcomes and second-look arthroscopic evaluations between anterior cruciate ligament (ACL) anteromedial (AM) bundle augmentation and single-bundle ACL reconstruction.
Purpose
We compared the clinical results and the second-look arthroscopic findings between (1) single-bundle ACL reconstruction in complete rupture and (2) ACL AM bundle augmentation in isolated AM bundle rupture.
Materials and methods
Two groups of patients underwent ACL surgery from January 2013 to December 2018. Group 1, who had 64 cases of single-bundle ACL reconstruction with second-look arthroscopy, and Group 2, who had 21 cases of AM bundle augmentation of ACL with second-look arthroscopy, were targeted. We evaluated and compared the clinical results (Lysholm score, Tegner activity score, Lachman test, and pivot-shift test) and synovialization at second-look arthroscopy before the operation and in the final follow-up period, between Group 1 and Group 2.
Results
The Lysholm score (p = 0.96) and Tegner activity score (p = 0.351) at final follow-up (mean 27.1 months) were 78.3 and 7.2 in Group 1 and 89.1 and 8.1 in Group 2, respectively. The Lachman test (p = 0.074) and pivot-shift test (p = 0.031) results at final follow-up were improved; however, there was no statistical significance. Second-look arthroscopy showed that percentages of synovialization area of grafted tendon at mean 15.6 months follow-up were 61.4% and 93.1% in Group 1 and Group 2, respectively (p = 0.008). The synovial coverage in Group 2 was higher than in Group 1.
Conclusion
The AM bundle augmentation for ACL injury in which the posterolateral bundle was preserved showed better clinical scores and synovial coverage than single-bundle ACL reconstruction for complete ACL rupture.
Level of evidence
The level of evidence is Level III, retrospective with case series.
Publisher
Springer Science and Business Media LLC
Subject
Orthopedics and Sports Medicine,Surgery
Reference21 articles.
1. Ochi M, Abouheif MM, Kongcharoensombat W, Nakamae A, Adachi N, Deie M (2011) Double bundle arthroscopic anterior cruciate ligament reconstruction with remnant preserving technique using a hamstring autograft. Sports Med Arthrosc Rehabil Ther Technol 5:3–30
2. Ochi M, Iwasa J, Uchio Y, Adachi N, Sumen Y (1999) The regeneration of sensory neurons in the reconstruction of the anterior cruciate ligament. J Bone Joint Surg Br 81(5):902–906
3. Takahashi T, Kondo E, Yasuda K, Miyatake S, Kawaguchi Y, Onodera J, Kitamura N (2016) Effects of remnant tissue preservation on the tendon graft in anterior cruciate ligament reconstruction: a biomechanical and histological study. Am J Sports Med 44(7):1708–1716
4. Kondo E, Yasuda K, Onodera J, Kawaguchi Y, Kitamura N (2015) Effects of remnant tissue preservation on clinical and arthroscopic results after anatomic double-bundle anterior cruciate ligament reconstruction. Am J Sports Med 43(8):1882–1892
5. Noh JH, Kyung HS, Roh YH, Kang TS (2017) Remnant-preserving and re-tensioning technique to cover the graft in anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 25(4):1205–1210
Cited by
6 articles.
订阅此论文施引文献
订阅此论文施引文献，注册后可以免费订阅5篇论文的施引文献，订阅后可以查看论文全部施引文献