Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction Using an Outside-in Technique: Two- to Six-Year Clinical and Radiological Follow-up.
OBJECTIVE
We evaluated the clinical and radiological outcomes of double-bundle anterior cruciate ligament (ACL) reconstruction using an outside-in technique with a follow-up of two- to six-years, especially in terms of the sports activity level and radiological degeneration.


METHODS
Sixty-seven patients who were available for a minimum two-year follow-up after double-bundle ACL reconstruction using an outside-in technique were retrospectively evaluated. The mean follow-up period was 43.7 months. The knee function and stability were evaluated before the operation, one year after the operation (short-term follow-up), and more than two years after the operation (last follow-up).


RESULTS
Regarding the knee function, the Lysholm score, International Knee Documentation Committee (IKDC) evaluation, and hop test showed significant improvement. Regarding the stability, the Lachman test, pivot shift test, KT-2000 arthrometer data, and anterior drawer radiographs using Telos showed significant improvement. Regarding the sports activity level, the patients who returned to pre-injury level activity was 68.7% according to the Tegner activity score and 76.1% according to the Cincinnati sports activity scale score. The incidence of aggravated degeneration or development of greater than IKDC grade A degeneration after surgery was 10.4%.


CONCLUSIONS
Double-bundle ACL reconstruction using an outside-in technique showed favorable clinical and radiological outcomes with respect to the knee function and stability, joint degeneraion, and, especially, return to pre-injury sports activity.
Department of Orthopaedic Surgery, Gil Hospital, Gachon University of Medicine and Science, Incheon, Korea.
Jae Ang
JA
Sim
Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Bundang, Korea.
Yong Seuk
YS
Lee
Gachon Medical Research Institute, Gil Hospital, Gachon University of Medicine and Science, Incheon, Korea.
Kyung Ok
KO
Kim
Department of Orthopaedic Surgery, Gil Hospital, Gachon University of Medicine and Science, Incheon, Korea.
Jong Keun
JK
Kim
Department of Orthopaedic Surgery, Gil Hospital, Gachon University of Medicine and Science, Incheon, Korea.
Beom Koo
BK
Lee
Anterior cruciate ligament; Double bundle; Outside-in technique; Reconstruction