title: Double-bundle ACL surgery demonstrates superior rotational kinematics to single-bundle technique during dynamic task.
abstract: BACKGROUND
  While traditional surgical repair of the anterior cruciate ligament is able to restore anterior-posterior knee stability, laxity in the transverse plane remains. Double-bundle reconstruction has demonstrated greater rotational restraint than the single-bundle technique under passive loading conditions; however, no comparison has been made under physiological weight-bearing conditions. The purpose of this study was to determine differences in rotational knee kinematics during a dynamic task in patients who had received either a single- or double-bundle reconstruction.
  
  
  METHODS
  Twenty-two patients exhibiting isolated anterior cruciate ligament rupture were randomly allocated either a single or double-bundle reconstruction. Three-dimensional knee kinematics were measured during a dynamic cutting activity prior to and following surgery. Functional range of rotation was compared between groups pre- and post-operatively and kinematics were assessed against uninjured control subjects.
  
  
  RESULTS
  No difference in overall range of rotation was found under physiological loading conditions. However, a significant interaction of the midpoint of the range of movement was observed; a greater external rotational shift in the single-bundle group followed reconstruction, while the kinematics of the double-bundle patient group shifted closer to those of the control group.
  
  
  CONCLUSIONS
  The double-bundle reconstruction demonstrated superior outcome in rotational kinematics to the single-bundle technique.
authors.affiliation: Department of Human Biology, University of Cape Town, South Africa. a.hemmerich@alumni.utoronto.ca
authors.forename: A
authors.initials: A
authors.lastname: Hemmerich
authors.forename: W
authors.initials: W
authors.lastname: van der Merwe
authors.forename: M
authors.initials: M
authors.lastname: Batterham
authors.forename: C L
authors.initials: CL
authors.lastname: Vaughan
mesh_terms: D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D001696:Biomechanical Phenomena; D005260:Female; D005684:Gait / Q000502:physiology; D006801:Humans; D007718:Knee Injuries / Q000503:physiopathology / Q000601:surgery*; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D012399:Rotation; D013710:Tendons / Q000601:surgery*; D016474:Weight-Bearing; D055815:Young Adult