Anterior cruciate ligament reconstruction with use of a single or double-bundle technique in patients with generalized ligamentous laxity.
BACKGROUND
In a patient with generalized ligamentous laxity, the risk of instability is greater with a conventionally reconstructed anterior cruciate ligament. The purpose of this study was to compare the clinical outcome of anterior cruciate ligament reconstruction done with a double-bundle technique with use of a quadriceps tendon-bone autograft and that of a single-bundle reconstruction with use of a bone-patellar tendon-bone autograft in patients with generalized ligamentous laxity.


METHODS
The records of sixty-one patients who underwent anterior cruciate ligament reconstruction between June 2002 and October 2005 were evaluated. Thirty-two patients underwent a single-bundle reconstruction (group 1), and twenty-nine patients underwent a double-bundle reconstruction (group 2). Clinical outcomes were determined from data obtained before surgery and at the twenty-four-month follow-up visit.


RESULTS
Postoperatively, the mean side-to-side difference (and standard deviation) in anterior tibial translation, measured with use of a KT-2000 arthrometer, was greater for group 1 (3.37 +/- 1.76 mm; range, 1.00 to 8.00 mm) than for group 2 (2.03 +/- 1.11 mm; range, 0.00 to 3.50 mm) (p = 0.02). Three patients in group 1 had a grade-1+ pivot shift, while no patient in group 2 had an abnormal pivot shift. The mean score on the Hospital for Special Surgery knee ligament questionnaire was 90.8 in group 1 and 92.1 in group 2, and the mean Lysholm score was 89.4 in group 1 and 91.1 in group 2.


CONCLUSIONS
On the basis of the evaluation of ligamentous laxity measured by the KT-2000 arthrometer, a double-bundle anterior cruciate ligament reconstruction with use of a quadriceps tendon-bone autograft allows less anterior translation than does a single-bundle reconstruction with use of a bone-patellar tendon-bone autograft. However, we could not identify a significant difference in the functional outcome between the two techniques.
Kim
Sung-Jae
SJ
Yonsei University Arthroscopy and Joint Research Institute, Yonsei University Health System, Seoul, South Korea. severanscopy@yuhs.ac
Chang
Ji-Hoon
JH
Kim
Tai-Won
TW
Jo
Seung-Bae
SB
Oh
Kyung-Soo
KS
D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D050376:Bone-Patellar Tendon-Bone Grafting; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000517:prevention & control; D007718:Knee Injuries / Q000601:surgery*; D008297:Male; D010808:Physical Examination; D011183:Postoperative Complications / Q000517:prevention & control; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013536:Suture Techniques; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult