title: Better 4-year outcomes for anterior cruciate ligament reconstruction with double-layer versus single-layer bone-patellar tendon-bone allografts.
abstract: OBJECTIVE
  To evaluate the results of anterior cruciate ligament reconstruction using a double-layer bone-patellar tendon-bone (DBPTB) graft.
  
  
  METHODS
  Between 2010 and 2011, 98 patients underwent anterior cruciate ligament reconstruction with an allograft. Forty-seven of these patients received a DBPTB allograft and 51 received a traditional monolayer BPTB graft. Outcomes were evaluated at the end of a minimum 4-year follow-up in both groups using KT 1000 arthrometer measurements, Lachman and pivot-shift tests, the International Knee Documentation Committee form, and Lysholm scores.
  
  
  RESULTS
  One patient (1/47, 2 %) in the DBPTB allograft group and six patients (6/51, 12 %) in the traditional monolayer BPTB graft were lost during follow-up because of graft rupture (n.s.). The mean side-to-side differences in the DBPTB and monolayer BPTB graft groups 4 years post-operatively were significantly different at 1.4 ± 1.3 and 1.7 ± 1.6 mm, respectively (p < 0.05). The DBPTB group performed significantly better than the BPTB group on the Lachman test, International Knee Documentation Committee knee score, and Lysholm scores (p < 0.05).
  
  
  CONCLUSIONS
  The DBPTB allograft group achieved better outcomes than the traditional BPTB allograft group regarding success rate, anterior stability, and knee function.
  
  
  METHODS
  Level II.
authors.affiliation: Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, China.
authors.forename: Yingzhen
authors.initials: Y
authors.lastname: Niu
authors.affiliation: Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, China.
authors.forename: Guman
authors.initials: G
authors.lastname: Duan
authors.affiliation: Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, China. niuyingzhen@yeah.net.
authors.forename: Fei
authors.initials: F
authors.lastname: Wang
authors.affiliation: Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, China.
authors.forename: Shiyu
authors.initials: S
authors.lastname: Tang
authors.affiliation: Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, China.
authors.forename: Jiangfeng
authors.initials: J
authors.lastname: Lu
authors.affiliation: Hospital for Special Surgery, 535 E. 70th Street, New York, NY, 10021, USA.
authors.forename: Xu
authors.initials: X
authors.lastname: Yang
mesh_terms: D000328:Adult; D064591:Allografts; D000070598:Anterior Cruciate Ligament Injuries / Q000601:surgery*; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods / Q000534:rehabilitation*; D050376:Bone-Patellar Tendon-Bone Grafting / Q000379:methods*; D064594:Bone-Patellar Tendon-Bone Grafts; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D011446:Prospective Studies; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
keywords: Allograft; Anterior cruciate ligament reconstruction; Bone-patellar tendon-bone; Double-layer