Comparable results between lateralized single- and double-bundle ACL reconstructions.
Patellar tendon autografts are not suitable for multibundle ACL reconstruction, a procedure that reportedly enhances postoperative knee stability. Biomechanical studies recommend lateral placement of the femoral tunnel for single-bundle reconstruction to improve postoperative knee kinematics. We asked whether a lateralized single-bundle patellar tendon graft (LSBP) would provide good short-term results of ACL reconstruction comparable to double-bundle hamstring tendon grafts (DBH). We prospectively followed 144 patients with unilateral ACL rupture treated with either LSBP or DBH in a nonrandomized fashion. Twenty-four female and 31 male patients with LSBP and 44 female and 26 male patients with DBH were followed for a minimum of 24 months (average, 38 months; range, 24-56 months). The patients with LSBP recovered knee extension better at 1 month compared with the patients with DBH, but extension was similar after 3 months. We observed no differences in the side-to-side difference of KT1000 measurement, pivot shift test, or anterior drawer test between LSBP and DBH. Although better recovery of hamstring strength in LSBP and better recovery of quadriceps strength in DBH were observed in the early postoperative period, these differences disappeared after 12 months. There was no difference in International Knee Documentation Committee objective evaluation between LSBP and DBH at the final followup.


METHODS
Level II, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Tsuda
Eiichi
E
Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Zaifu-cho 5, Hirosaki, Aomori 036-8562, Japan. eiichi@cc.hirosaki-u.ac.jp
Ishibashi
Yasuyuki
Y
Fukuda
Akira
A
Tsukada
Harehiko
H
Toh
Satoshi
S
D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D010329:Patella / Q000601:surgery; D017847:Patellar Ligament / Q000637:transplantation*; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult