title: Double-layer versus single-layer bone-patellar tendon-bone anterior cruciate ligament reconstruction: a prospective randomized study with 3-year follow-up.
abstract: OBJECTIVE
  To evaluate the clinical results of a randomized controlled trial of single-layer versus double-layer bone-patellar tendon-bone (BPTB) anterior cruciate ligament (ACL) reconstruction.
  
  
  METHODS
  Fifty-eight subjects who underwent primary ACL reconstruction with a BPTB allograft were prospectively randomized into two groups: single-layer reconstruction (n = 31) and double-layer reconstruction (n = 27). The following evaluation methods were used: clinical examination, KT-1000 arthrometer measurement, muscle strength, Tegner activity score, Lysholm score, subjective rating scale regarding patient satisfaction and sports performance level, graft retear, contralateral ACL tear, and additional meniscus surgery.
  
  
  RESULTS
  Forty-eight subjects (24 in single-layer group and 24 in double-layer group) who were followed up for 3 years were evaluated. Preoperatively, there were no differences between the groups. At 3-year follow-up, the Lachman and pivot-shift test results were better in the double-layer group (P = 0.019 and P < 0.0001, respectively). KT measurements were better in the double-layer group (mean 2.9 versus 1.5 mm; P = 0.0025). The Tegner score was also better in the double-layer group (P = 0.024). There were no significant differences in range of motion, muscle strength, Lysholm score, subjective rating scale, graft retear, and secondary meniscal tear.
  
  
  CONCLUSIONS
  In ACL reconstruction, double-layer BPTB reconstruction was significantly better than single-layer reconstruction regarding anterior and rotational stability at 3-year follow-up. The results of KT measurements and the Lachman and pivot-shift tests were significantly better in the double-layer group, whereas there was no difference in the anterior drawer test results. The Tegner score was also better in the double-layer group; however, there were no differences in the other subjective findings.
authors: Orthopedic Department, The Affiliated Taizhou people's Hospital of Nantong University, Taizhou, 225300, Jiangsu, People's Republic of China.
authors: Xiaoliang
authors: X
authors: Mei
authors: Orthopedic Department, The Affiliated Taizhou people's Hospital of Nantong University, Taizhou, 225300, Jiangsu, People's Republic of China.
authors: Zhenxiang
authors: Z
authors: Zhang
authors: Orthopedic Department, The Affiliated Taizhou people's Hospital of Nantong University, Taizhou, 225300, Jiangsu, People's Republic of China. jingwenyang1982@126.com.
authors: Jingwen
authors: J
authors: Yang
mesh_terms: D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D065466:Lysholm Knee Score; D008297:Male; D053580:Muscle Strength / Q000502:physiology; D010329:Patella / Q000637:transplantation*; D017847:Patellar Ligament / Q000601:surgery; D017060:Patient Satisfaction; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology; D013710:Tendons / Q000637:transplantation*; D014184:Transplantation, Homologous
keywords: Allograft; Anterior cruciate ligament; Bone-patellar tendon-bone; Double-layer; Single-layer