title: Single- versus bi-socket anterior cruciate ligament reconstruction using autogenous multiple-stranded hamstring tendons with endoButton femoral fixation: A prospective study.
abstract: OBJECTIVE
  This prospective study was conducted to compare the single-socket and the bi-socket anterior cruciate ligament (ACL) reconstruction techniques in terms of outcome.
  
  
  METHODS
  Nonrandomized control trial.
  
  
  METHODS
  There were 160 consecutive patients with unilateral chronic ACL insufficiency who underwent endoscopic single- or bi-socket ACL reconstruction alternately using multiple-stranded medial hamstring tendon and EndoButton (Smith & Nephew, Andover, MD) femoral fixation. All patients underwent the same postoperative rehabilitation protocol. Of them, 106 patients (57 single, 49 bi) were available for 2-year follow-up.
  
  
  RESULTS
  According to the IKDC Knee Ligament Evaluation Form, 23 patients (40%) of the single-socket group were subjectively graded as normal, 30 (53%) as nearly normal, and 4 (7%) as abnormal. Twenty-six patients (53%) of the bi-socket group were graded as normal, 21 (43%) as nearly normal, and 2 (4%) as abnormal (P =.19). The mean side-to-side anterior laxity difference (KT-1000 manual maximum force) was 0.9 +/- 1.8 mm for the single-socket group and 0.7 +/- 1.2 mm for the bi-socket group (P =.44). Fifty-three of 57 patients (93%) in the single-socket group and all patients in the bi-socket group showed anterior laxity differences of +/-3 mm or less (P =.12). There were no differences in thigh muscle strength between the groups.
  
  
  CONCLUSIONS
  Both single- and bi-socket ACL reconstruction using autogenous multiple-stranded hamstring tendons with EndoButton fixation provided satisfactory anterior stability, and there were no statistically significant differences in subjective results or measured restored stability between the 2 groups.
authors.affiliation: Departments of Orthopaedic Surgery and Orthopaedic Sports Medicine, Osaka University Medical School, Osaka, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Hamada
authors.forename: K
authors.initials: K
authors.lastname: Shino
authors.forename: S
authors.initials: S
authors.lastname: Horibe
authors.forename: T
authors.initials: T
authors.lastname: Mitsuoka
authors.forename: T
authors.initials: T
authors.lastname: Miyama
authors.forename: Y
authors.initials: Y
authors.lastname: Shiozaki
authors.forename: T
authors.initials: T
authors.lastname: Mae
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D001182:Arthroscopy; D001864:Bone Wires; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery; D008875:Middle Aged; D011446:Prospective Studies; D020127:Recovery of Function; D013710:Tendons / Q000637:transplantation*; D014182:Transplantation, Autologous