Affiliation:
1. Department of Sports Medicine and Joint Reconstruction Surgery, Hokkaido University School of Medicine, Sapporo, Japan
2. Department of Orthopaedic Surgery, Sapporo City General Hospital, Sapporo, Japan
3. Department of Orthopaedic Surgery, Yamanote-dori Yagi Hospital, Sapporo, Japan
Abstract
Background Several trials have been conducted to compare the clinical results between anatomic double-bundle and single-bundle anterior cruciate ligament (ACL) reconstruction procedures. In these studies, however, the number of patients was insufficient to compare the clinical results of the 2 procedures. Hypothesis The anatomic double-bundle procedure may be significantly better concerning the anterior laxity and the pivot-shift test than the single-bundle procedure, while there may be no significant differences in the other clinical evaluations and the intraoperative and postoperative complications between the 2 procedures. Study Design Cohort study; Level of evidence, 2. Methods Three hundred and twenty-eight patients with unilateral ACL reconstruction using hamstring autografts were divided into 2 groups. The first 157 consecutive patients underwent single-bundle reconstruction and the remaining 171 patients underwent anatomic double-bundle reconstruction. Concerning all background factors, there were no statistical differences between the 2 groups. Each patient was examined 2 years after surgery. Results No serious complications were experienced in either group. The anterior laxity was significantly less in the double-bundle reconstruction (mean, 1.2 mm) than in the single-bundle reconstruction (mean, 2.5 mm). In the pivot-shift test, the double bundle (+ indication 16%; ++, 3%) was significantly better than the single bundle (+ result, 37%; ++, 12%). The mean Lysholm score averaged 96.5 points’ and 97.3 points in single-bundle and double-bundle reconstructions, respectively, while the International Knee Documentation Committee evaluation showed that 90 and 110 patients, respectively, were evaluated as rank A (no significant difference between groups). There were no significant differences in the other clinical evaluations and the complications between the 2 procedures. Conclusions The postoperative anterior and rotational stability after the anatomic double-bundle ACL reconstruction was significantly better than that after the single-bundle reconstruction, although there were no significant differences between the 2 Procedures concerning the complications and the clinical evaluations.
Subject
Physical Therapy, Sports Therapy and Rehabilitation,Orthopedics and Sports Medicine
Cited by
260 articles.
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