Clinical evaluation of anatomic double-bundle anterior cruciate ligament reconstruction procedure using hamstring tendon grafts: comparisons among 3 different procedures.
OBJECTIVE
To compare the clinical outcome of anatomic double-bundle anterior cruciate ligament (ACL) reconstruction with that of nonanatomic single- and double-bundle reconstructions.


METHODS
Prospective comparative cohort study.


METHODS
Seventy-two patients with unilateral ACL-deficient knees were randomly divided into 3 groups. Concerning all background factors, there were no statistical differences among the 3 groups. In group S (n = 24), single-bundle ACL reconstruction was performed. In group N-AD (n = 24), nonanatomic double-bundle reconstruction was carried out. In group AD (n = 24), anatomic double-bundle reconstruction was performed. One surgeon performed all operations using hamstring tendon autografts. Each patient underwent clinical examinations, before surgery and at 2 years.


RESULTS
No intraoperative and postoperative complications were experienced in each group. There were no significant differences concerning the time for operation among the 3 groups. The statistical analysis showed a significant difference in the postoperative side-to-side anterior laxity among the 3 groups (P = .006). The laxity was significantly less (P = .002) in group AD (1.1 mm) than in group S (2.8 mm), while there was no significant difference (P = .072) between groups AD and N-AD. Concerning the pivot-shift test, group AD was significantly superior to group S (P = .025). There were no significant differences in the range of knee motion, the muscle torque, and the International Knee Documentation Committee evaluation.


CONCLUSIONS
On the basis of the KT-2000 measurement, the side-to-side anterior laxity of our anatomic double-bundle ACL reconstruction was significantly better than that of the single-bundle reconstruction with the hamstring tendon graft, although there were no significant differences in the other clinical measures among any of the 3 procedures.


METHODS
Level II.
Yasuda
Kazunori
K
Department of Sports Medicine and Joint Reconstruction Surgery, Hokkaido University School of Medicine, Sapporo, Japan. yasukaz@med.hokudai.ac.jp
Kondo
Eiji
E
Ichiyama
Hiroki
H
Tanabe
Yoshie
Y
Tohyama
Harukazu
H
D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy / Q000379:methods*; D001265:Athletic Injuries / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D005269:Femur / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019736:Prostheses and Implants; D016059:Range of Motion, Articular; D016037:Single-Blind Method; D013710:Tendons / Q000637:transplantation*; D013977:Tibia / Q000601:surgery; D014182:Transplantation, Autologous; D016896:Treatment Outcome