title: Triple-bundle ACL grafts evaluated by second-look arthroscopy.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the morphology of transplanted triple-bundle anterior cruciate ligament (ACL) grafts by second-look arthroscopy.
  
  
  METHODS
  The subjects were 41 patients with a mean age of 25.5 ± 8.5 years who underwent second-look arthroscopy at between 6 and 22 months after the anatomical triple-bundle ACL reconstruction using semitendinosus tendon autograft. Lachman test was negative in 38 knees and mildly positive with a firm endpoint in 3 knees. Arthroscopic evaluation of grafts was performed for the anteromedial graft (AM), the intermediate graft (IM), and the posterolateral graft (PL), focusing on tension and graft damage.
  
  
  RESULTS
  All grafts showed "fan-out" shape approaching the tibial attachment, which looked closer to the natural ACL compared to the double-bundle grafts. As to graft tension, 93% of AM, 90% of IM, and 88% of PL grafts were evaluated as taut, respectively. As to graft damage, there was no apparent rupture in the AM and IM grafts, while complete or substantial rupture was observed in 10% of PL grafts around the femoral tunnel aperture. The incidence of graft rupture in PL grafts was significantly greater than those in the AM and IM grafts. As to synovial coverage, 76% of AM, 78% of IM, and 59% of PL grafts were evaluated as "Good," while 41% of PL grafts were not fully covered with synovium. All of the synovial defects were observed around the femoral tunnel aperture.
  
  
  CONCLUSIONS
  The morphology of the triple-bundle grafts resembled that of the natural ACL, while complete or substantial rupture was observed in 10% of the PL grafts.
  
  
  METHODS
  Study of case series with no comparison group, Level IV.
authors: Department of Sports Orthopaedics, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Kita-ku, Sakai, Osaka, 583-8555, Japan. yoshi-tanaka@iris.eonet.ne.jp
authors: Yoshinari
authors: Y
authors: Tanaka
authors: Konsei
authors: K
authors: Shino
authors: Shuji
authors: S
authors: Horibe
authors: Norimasa
authors: N
authors: Nakamura
authors: Shigeto
authors: S
authors: Nakagawa
authors: Tatsuo
authors: T
authors: Mae
authors: Hidenori
authors: H
authors: Otsubo
authors: Tomoyuki
authors: T
authors: Suzuki
authors: Ken
authors: K
authors: Nakata
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