title: Second-look arthroscopic evaluation of the articular cartilage after primary single-bundle and double-bundle anterior cruciate ligament reconstructions.
abstract: BACKGROUND
  Several reports have shown the progression of articular cartilage degeneration after anterior cruciate ligament (ACL) reconstruction. No report has been published about the cartilage comparing changes after single-bundle (SB) and double-bundle (DB) ACL reconstructions. The purpose of this study was to evaluate the articular cartilage changes after SB and DB ACL reconstructions by second-look arthroscopy.
  
  
  METHODS
  Ninety-nine patients who received arthroscopic ACL reconstruction were retrospectively reviewed at an average of 14 months after reconstruction, 58 patients underwent SB ACL reconstruction and 41 patients underwent DB ACL reconstruction. Hamstring tendon autografts were used in all patients. Second-look arthroscopy was done in conjunction with the tibial staple fixation removal at least one year after the initial ACL reconstruction. Arthroscopic evaluation and grading of the articular cartilage degeneration for all patients were performed at the initial ACL reconstruction, and at the second-look arthroscopy.
  
  
  RESULTS
  The average cartilage degeneration at the patellofemoral joint (PFJ) was found significantly worsened after both SB and DB ACL reconstructions. This worsening were not seen at medial tibiofemoral joint (TFJ) and lateral TFJ. Grade II cartilage damage was the most common. At second-look arthroscopy, the average patellar cartilage degeneration was 1.14 ± 0.14 (at first look 0.52 ± 0.11) for the SB group, and 1.22 ± 0.15 (at first look 0.56 ± 0.12) for the DB group. The average trochlear cartilage degeneration was 1.05 ± 0.16 (at fist look 0.10 ± 0.06) and 0.66 ± 0.17 (at fist look 0.17 ± 0.09), respectively. The average patellar cartilage degeneration showed no significant difference in both groups. However, the average trochlea cartilage degeneration in DB group was significantly less than in SB group.
  
  
  CONCLUSIONS
  Patellofemoral cartilage degeneration continued to aggravate after ACL reconstruction. DB ACL reconstruction could significantly decrease the trochlea cartilage degeneration compared with SB ACL reconstruction.
authors.affiliation: Institute of Sports Medicine, Peking University Third Hospital, Beijing 100191, China.
authors.forename: Hai-Jun
authors.initials: HJ
authors.lastname: Wang
authors.forename: Ying-Fang
authors.initials: YF
authors.lastname: Ao
authors.forename: Lian-Xu
authors.initials: LX
authors.lastname: Chen
authors.forename: Xi
authors.initials: X
authors.lastname: Gong
authors.forename: Yong-Jian
authors.initials: YJ
authors.lastname: Wang
authors.forename: Yong
authors.initials: Y
authors.lastname: Ma
authors.forename: Kevin Kar Ming
authors.initials: KK
authors.lastname: Leung
authors.forename: Jia-Kuo
authors.initials: JK
authors.lastname: Yu
mesh_terms: D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D001182:Arthroscopy / Q000379:methods*; D002358:Cartilage, Articular / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D024162:Second-Look Surgery / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult