title: A prospective randomised study of anatomical single-bundle versus double-bundle anterior cruciate ligament reconstruction: quantitative evaluation using an electromagnetic measurement system.
abstract: We conducted a prospective randomised study of anatomical single-bundle (A-SB group) versus double-bundle (A-DB group) anterior cruciate ligament (ACL) reconstruction using the hamstrings tendons. Twenty patients with unilateral ACL deficiency were randomised into two groups. We created the bone tunnels at the position of the original insertion of the anteromedial bundle footprint and posterolateral bundle footprint in the A-DB group and at the central position between these two bundles in the A-SB group. All of the patients were tested before ACL reconstruction and one year after surgery. The KT-1000 measurements, isokinetic muscle peak torque and heel-height difference were evaluated and the general knee condition was assessed by Lysholm score. For pre- and postoperative stability assessment, we used the six-degrees-of-freedom of knee kinematic measurement system using an electromagnetic device (the EMS) for quantitative assessment during the Lachman test and the pivot shift test. There were no significant differences in the KT-1000 measurements, isokinetic muscle peak torque, heel-height difference, and Lysholm score at one-year follow-up between these two groups. The EMS data showed there were significant differences in the acceleration of the pivot shift test between the operated knee and the contralateral normal knees in the A-SB group. In conclusion, clinical outcomes were equally good in both groups. However, the EMS data showed the anatomical double-bundle ACL reconstruction tended to be biomechanically superior to the single-bundle reconstruction.
authors: Department of Orthopaedic Surgery, Graduate School of Medicine, Kobe University, Kobe-city, 650-0017, Japan. isuke@pop21.odn.ne.jp
authors: Daisuke
authors: D
authors: Araki
authors: Ryosuke
authors: R
authors: Kuroda
authors: Seiji
authors: S
authors: Kubo
authors: Norifumi
authors: N
authors: Fujita
authors: Katsumasa
authors: K
authors: Tei
authors: Koji
authors: K
authors: Nishimoto
authors: Yuichi
authors: Y
authors: Hoshino
authors: Takehiko
authors: T
authors: Matsushita
authors: Tomoyuki
authors: T
authors: Matsumoto
authors: Koki
authors: K
authors: Nagamune
authors: Masahiro
authors: M
authors: Kurosaka
mesh_terms: D000328:Adult; D016118:Anterior Cruciate Ligament / Q000503:physiopathology / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy / Q000379:methods*; D001696:Biomechanical Phenomena; D055590:Electromagnetic Phenomena; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery; D008297:Male; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D013710:Tendons / Q000637:transplantation*; D016896:Treatment Outcome