title: Short-Term Study of the Outcome of a New Instrument for All-Inside Double-Bundle Anterior Cruciate Ligament Reconstruction.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the short-term clinical results and location of the bone tunnel with a new surgical procedure for all-inside double-bundle anterior cruciate ligament (ACL) reconstruction.
  
  
  METHODS
  The double-bundle ACL reconstruction procedure was performed in 24 patients (13 male and 11 female patients) with a mean age of 31.0 years. Anterior and posterior tibial translation using an arthrometer (KT-1000; MEDmetric, San Diego, CA) and the Lysholm score were measured before surgery and at a mean of 24.8 months (range, 13 to 45 months) postoperatively. Computed tomography scans were taken to evaluate the bone tunnel positions using 3-dimensional images with the quadrant method for the femoral tunnel and Stäubli's technique for the tibial tunnel.
  
  
  RESULTS
  Three-dimensional computed tomography scans showed that the anteromedial and posterolateral tunnels were placed in anatomically appropriate positions. Arthrometric measurements showed that the mean side-to-side differences were 5.3 mm (SD, 1.6 mm) preoperatively and 0.05 mm (SD, 0.7 mm) at a mean of 24.8 months postoperatively, indicating a remarkable improvement (P < .00001). The mean Lysholm score was 56.3 points (SD, 14.8 points) preoperatively and 95.5 points (SD, 3.8 points) at final follow-up and was significantly improved after the operation (P < .00001).
  
  
  CONCLUSIONS
  The all-inside double-bundle ACL reconstruction technique used in this study resulted in the creation of tunnels in an anatomically appropriate position. Short-term clinical follow-up showed improvement in patient-reported outcomes and knee stability. This technique may provide an alternative option for all-inside ACL reconstruction.
  
  
  METHODS
  Level IV, therapeutic case series.
authors.affiliation: Department of Orthopaedic Surgery, Ehime University Graduate School of Medicine, Tōon, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Watanabe
authors.affiliation: Department of Orthopaedic Surgery, Ehime University Graduate School of Medicine, Tōon, Japan. Electronic address: takahast@m.ehime-u.ac.jp.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Takahashi
authors.affiliation: Department of Orthopaedic Surgery, Ehime University Graduate School of Medicine, Tōon, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Hino
authors.affiliation: Department of Orthopaedic Surgery, Ehime University Graduate School of Medicine, Tōon, Japan.
authors.forename: Tatsuhiko
authors.initials: T
authors.lastname: Kutsuna
authors.affiliation: Department of Orthopaedic Surgery, Ehime University Graduate School of Medicine, Tōon, Japan.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Ohnishi
authors.affiliation: Department of Orthopaedic Surgery, Ehime University Graduate School of Medicine, Tōon, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Ishimaru
authors.affiliation: Department of Orthopaedic Surgery, Ehime University Graduate School of Medicine, Tōon, Japan.
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Miura
mesh_terms: D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D005260:Female; D005269:Femur / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional; D007593:Joint Instability / Q000601:surgery; D007719:Knee Joint / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D013977:Tibia / Q000601:surgery; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D055815:Young Adult