title: Comparison of the clinical outcome of double-bundle, anteromedial single-bundle, and posterolateral single-bundle anterior cruciate ligament reconstruction using hamstring tendon graft with minimum 2-year follow-up.
abstract: OBJECTIVE
  The purpose of this study was to obtain more than 2 years' follow-up after surgery to investigate the effect of the difference in rotatory stability based on our previous data on the clinical outcome among 3 groups: double-bundle (DB) reconstruction group, anteromedial (AM) single-bundle reconstruction group, and posterolateral (PL) single-bundle reconstruction group.
  
  
  METHODS
  We randomly separated 55 patients with anterior cruciate ligament rupture into 3 groups: 18 in DB group, 18 in AM group, and 19 in PL group. The mean follow-up period is 33.7 months for the DB group, 31.9 months for the AM group, and 33.2 months for the PL group. We evaluated the Lysholm score, Tegner score, anterior laxity with the KT-1000 arthrometer (MEDmetric, San Diego, CA), rotator instability with the pivot-shift test, and muscle strength with knee extensor and flexor isokinetic peak torques at 60°/s.
  
  
  RESULTS
  There were no significant differences in postoperative Lysholm score and Tegner score. Anterior stability of the knee, as measured by the KT-1000 arthrometer, was significantly better in the DB group than the PL group (P < .05). The negative rate of the manual pivot-shift test in the DB group was significantly superior to the PL group (P < .05). Muscle strength of the extensor in the DB group was significantly superior to that in the AM group (P < .05), and muscle strength of the flexor in the PL group was significantly inferior to that in both the DB and AM groups (P < .05). Two patients in the PL group had rerupture; however, there was no graft failure in the other groups.
  
  
  CONCLUSIONS
  At 2 years' follow-up, patients undergoing DB anterior cruciate ligament reconstruction had greater extension strength than patients receiving an AM single-bundle reconstruction. The DB and AM groups had greater flexion strength than the PL group. The DB and AM groups had a similar rate of negative pivot-shift test results, whereas the PL group had fewer negative pivot-shift test results than the DB group. There were no KT-1000 side-to-side differences between the DB and AM groups, whereas the DB group had better results than the PL group. Overall, the clinical outcome as measured by Lysholm and Tegner scores was not different between groups.
  
  
  METHODS
  Level II, prospective comparative study.
authors.affiliation: Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Norifumi
authors.initials: N
authors.lastname: Fujita
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Kuroda
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Motoi
authors.initials: M
authors.lastname: Yamaguchi
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Yagi
authors.forename: Akio
authors.initials: A
authors.lastname: Matsumoto
authors.forename: Seiji
authors.initials: S
authors.lastname: Kubo
authors.forename: Takehiko
authors.initials: T
authors.lastname: Matsushita
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Hoshino
authors.forename: Koji
authors.initials: K
authors.lastname: Nishimoto
authors.forename: Daisuke
authors.initials: D
authors.lastname: Araki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kurosaka
mesh_terms: D000328:Adult; D016118:Anterior Cruciate Ligament / Q000473:pathology / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D055590:Electromagnetic Phenomena; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000503:physiopathology; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012008:Recurrence; D012421:Rupture; D013710:Tendons / Q000637:transplantation*; D013848:Thigh; D013977:Tibia / Q000503:physiopathology; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000503:physiopathology; D055815:Young Adult