title: One- versus two-incision technique for anterior cruciate ligament reconstruction with patellar tendon graft. Results on early rehabilitation and stability.
abstract: Anterior cruciate ligament (ACL) reconstruction with patellar tendon graft has become a standard procedure. The graft can be inserted either using two tunnels and a lateral femoral incision or with a femoral half-tunnel drilled from the joint, thus avoiding the lateral incision. Advantages have been claimed for the single-incision technique in the early rehabilitation period. Forty patients with ACL deficiency were included in a prospective randomized trial comparing the single- and two-incision technique with a follow-up period of 12 months. Preoperative data did not show any significant difference between the two groups. At early follow-up no differences were observed with respect to complications or the progress of rehabilitation. Evaluation at 12 months postoperatively using the IKDC form revealed good to excellent results in 70% of patients. ACL reconstruction reduced anterior translation of the knee significantly at the 6-month and 12-month follow-up with a slight increase of MMD values at 12 months in both groups. The arthroscopic single-incision technique did not differ from the mini-open technique in terms of postoperative pain medication, incidence of effusion, postoperative range-of-motion or any rehabilitation parameters. Stability was comparable in both groups at all time periods. We conclude that an arthroscopic single-incision technique has no advantage over a mini-open two-incision technique for ACL reconstruction with patellar tendon graft in terms of subjective or objective parameters.
authors.affiliation: Trauma Department, Hannover Medical School, Germany.
authors.forename: T G
authors.initials: TG
authors.lastname: Gerich
authors.forename: C
authors.initials: C
authors.lastname: Lattermann
authors.forename: R W
authors.initials: RW
authors.lastname: Fremerey
authors.forename: J
authors.initials: J
authors.lastname: Zeichen
authors.forename: H P
authors.initials: HP
authors.lastname: Lobenhoffer
mesh_terms: D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000534:rehabilitation / Q000601:surgery*; D008297:Male; D010329:Patella; D011446:Prospective Studies; D012421:Rupture; D013710:Tendons / Q000637:transplantation*; D014182:Transplantation, Autologous; D016896:Treatment Outcome