Comparison of single- and double-bundle anterior cruciate ligament reconstruction using quadriceps tendon-bone autografts.
OBJECTIVE
The purpose of this study was to evaluate and compare postoperative knee stability and functional scores between single- and double- bundle anterior cruciate ligament (ACL) reconstruction with the use of quadriceps tendon-bone autografts at a 2-year follow-up.


METHODS
The records of 59 patients who had ACL reconstruction between January 2005 and April 2006 were analyzed retrospectively. Twenty-eight patients had single-bundle reconstruction (group S) and 31 received double-bundle reconstruction (group D). Ligament stability was assessed with the Lachman and pivot-shift tests and a KT-2000 arthrometer. International Knee Documentation Committee (IKDC) and Lysholm scores were employed to evaluate the functional outcomes.


RESULTS
The postoperative mean side-to-side difference for group S was 2.64 mm and 1.79 mm for group D, a difference that was found to be statistically significant (P = .020). Regarding the pivot-shift test, 3 patients had grade 1+ and 1 patient had grade 2+ pivot-shift in group S, while no patients had abnormal pivot-shift in group D (P = .093). The patients who reported grade A or B on IKDC scores were 24 and 28 in group S and D, respectively (P > .1). On the questionnaire of the twisting activity, although statistical difference was not found between the groups, there was a trend toward more restriction in twisting activity in group S (P = .096). We found significant correlation between the twisting activity and instability questionnaire of the Lysholm score (Spearman coefficient, 0.737; P < .001).


CONCLUSIONS
Double-bundle ACL reconstruction using quadriceps tendon-bone autografts provide less laxity (1.79 mm) than single-bundle ACL reconstruction (2.64 mm) as measured by the KT-2000. However, we could not find any significant differences in the functional measurements between the 2 groups.


METHODS
Level III, retrospective comparative study.
Kim
Sung-Jae
SJ
Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea.
Jo
Seung-Bae
SB
Kumar
Praveen
P
Oh
Kyung-Soo
KS
D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D005260:Female; D005269:Femur / Q000637:transplantation*; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D052097:Quadriceps Muscle / Q000637:transplantation*; D016059:Range of Motion, Articular / Q000502:physiology; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012421:Rupture; D013710:Tendons / Q000637:transplantation*; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult