Comparison of outcome after anatomic double-bundle and antero-medial portal non-anatomic single-bundle reconstruction in ACL-injured patients.
OBJECTIVE
The aim of this study was to compare anatomic double-bundle anterior cruciate ligament reconstruction with non-anatomic single-bundle reconstruction.


METHODS
In a prospective consecutive series, 94 unselected patients [45 anatomic double-bundle (ADB) and 49 non-anatomic single-bundle (SB)] underwent ACL reconstruction involving hamstring tendon autograft, interference screw fixation on both the femoral and tibial side and drilling the femoral tunnel(s) through the antero-medial portal in both groups. In the ADB group, the remnants of the ACL were identified and the grafts were placed anatomically. In the SB group, traditional placement of the graft was performed in a less anatomic manner. Pre-operatively, the groups were comparable in terms of age, gender, time between injury and operation and associated injuries. One independent physiotherapist performed all the pre-operative and post-operative assessments.


RESULTS
The follow-up period was 26 (22-34) and 24 (23-30) months in the ADB and SB groups, respectively (p = 0.005). At follow-up, 78 % in the ADB group and 74 % in the SB group had a negative pivot-shift test (n.s.). The KT-1000 134N measurements were 2 (-5 to 10.5) and 2 (-4 to 7) mm in the ADB and SB groups, respectively (n.s.). At follow-up, the extension deficit was significantly larger in the ADB group than in the SB group (p = 0.001). The Tegner activity scale was significantly higher in the ADB group both pre-operatively and at follow-up (p = 0.03 and p = 0.004). In overall terms, both groups had improved significantly at the two-year follow-up.


CONCLUSIONS
In an unselected group of ACL-injured patients, anatomic double-bundle reconstruction did not result in better rotational or antero-posterior stability measurements than antero-medial portal non-anatomic single-bundle reconstruction at the two-year follow-up.


METHODS
III.
Department of Orthopaedics, NU Hospital Group, 451 80, Uddevalla, Trollhättan, Sweden. ioannis.karikis@vgregion.se.|Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. ioannis.karikis@vgregion.se.
Ioannis
I
Karikis
Ortho Center, IFK Clinic, Gothenburg, Sweden.|Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Mattias
M
Ahldén
Department of Orthopaedics, NU Hospital Group, 451 80, Uddevalla, Trollhättan, Sweden.
Abraham
A
Casut
Department of Research and Development, NU Hospital Group, Trollhättan, Sweden.|Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Ninni
N
Sernert
Department of Orthopaedics, NU Hospital Group, 451 80, Uddevalla, Trollhättan, Sweden.|Department of Research and Development, NU Hospital Group, Trollhättan, Sweden.|Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Jüri
J
Kartus
D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D001863:Bone Screws; D005260:Female; D005269:Femur / Q000601:surgery; D005500:Follow-Up Studies; D000070632:Hamstring Tendons / Q000637:transplantation; D006801:Humans; D065466:Lysholm Knee Score; D008297:Male; D011446:Prospective Studies; D013977:Tibia / Q000601:surgery; D014182:Transplantation, Autologous; D016896:Treatment Outcome
Anterior cruciate ligament; Double bundle; Hamstrings tendon; Non-anatomic single bundle; Outcome; Reconstruction