Comparison of Tunnel Enlargement and Clinical Outcome Between Bioabsorbable Interference Screws and Cortical Button-Post Fixation in Arthroscopic Double-Bundle Anterior Cruciate Ligament Reconstruction: A Prospective, Randomized Study With a Minimum Follow-Up of 2 Years

Abstract Purpose We modified the hamstring tendon graft into the hamstring-bone composite graft in double-bundle anterior cruciate ligament reconstruction for anterior cruciate ligament (ACL) injuries. Here, we evaluated the technique's effectiveness by investigating the clinical results in restoring the stability and function of the knee joint. Methods We reviewed 42 patients who underwent anterior cruciate ligament reconstruction (ACLR) with the hamstring-bone graft for ACL injuries from January 2013 to April 2015, with an average follow-up of 66.6 months. The objective evaluations (KT-1000, Lachman test and pivot-shift test) and the subjective evaluations (International Knee Documentation Committee (IKDC) scores, Lysholm scores, and Tegner scores) were performed preoperatively and postoperatively. Results Forty-one of 42 patients were negative in the Lachman test and forty of 42 patients were negative in the pivot-shift test after the operation at the final follow-up time. The IKDC, Lysholm, and Tegner scores improved significantly from 56.24±9.28 to 85.33±3.37, from 62.00±11.09 to 90.43±3.71，and from 2.3±0.87 to 6.5±0.67 at the final follow-up. Conclusion Double-bundle anatomic ACLR with a hamstring-bone composite graft can restore the anteroposterior and rotational stability for ACL injuries. The modified technique can provide excellent clinical outcomes with a long-term follow-up.

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Prospective Comparative Study of Anterior Cruciate Ligament Reconstruction Using the Double-Bundle and Single-Bundle Techniques

The American Journal of Sports Medicine ◽

10.1177/0363546509333478 ◽

2009 ◽

Vol 37 (9) ◽

pp. 1705-1711 ◽

Cited By ~ 52

Author(s):

Eun Kyoo Song ◽

Luke S. Oh ◽

Thomas J. Gill ◽

Guoan Li ◽

Hemanth R. Gadikota ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Anterior Cruciate Ligament Reconstruction ◽

Clinical Outcomes ◽

Ligament Reconstruction ◽

Cruciate Ligament ◽

Double Bundle ◽

Single Bundle ◽

Cruciate Ligament Reconstruction ◽

Anterior Cruciate

Background The intent of double-bundle anterior cruciate ligament reconstruction is to reproduce the normal anterior cruciate ligament anatomy and improve knee joint rotational stability. However, no consensus has been reached on the advantages of this technique over the single-bundle technique. Hypothesis We hypothesized that double-bundle anterior cruciate ligament reconstruction could provide better intraoperative stability and clinical outcome than single-bundle reconstruction. Type of study: Cohort study; Level of evidence, 2. Methods Forty patients with anterior cruciate ligament injury in one knee were recruited; 20 were allocated to a double-bundle anterior cruciate ligament reconstruction group and 20 to a single-bundle anterior cruciate ligament reconstruction group. Intraoperative stabilities at 30° of knee flexion were compared between the 2 groups using a navigation system. Clinical outcomes including Lysholm knee scores, Tegner activity scores, Lachman and pivot-shift test results, and radiographic stabilities were also compared between the 2 groups after a minimum of 2 years of follow-up. Results Intraoperative anterior and rotational stabilities after anterior cruciate ligament reconstruction in the double-bundle group were significantly better than those in single-bundle group (P = .020 and P < .001, respectively). Nineteen patients (95%) in each group were available at a minimum 2-year follow-up. Clinical outcomes including Lysholm knee and Tegner activity scores were similar in the 2 groups at 2-year follow-up (P > .05). Furthermore, stability results of the Lachman and pivot-shift tests, and radiologic findings at 2-year follow-up failed to reveal any significant intergroup differences (P > .05). Conclusion Although double-bundle anterior cruciate ligament reconstruction produces better intraoperative stabilities than single-bundle anterior cruciate ligament reconstruction, the 2 modalities were found to be similar in terms of clinical outcomes and postoperative stabilities after a minimum of 2 years of follow-up.

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