A comparative study of single-and double-bundle ACL reconstructions in sheep

Radford, W. J. P.; Amis, Andrew A.; Kempson, S. A.; Stead, A. C.; Camburn, M.A.

doi:10.1007/bf01476480

Cited by 37 publications

(35 citation statements)

References 13 publications

(31 reference statements)

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“…Also concerning rigidity, the behavior of both groups was similar, but the control group showed lower values at all positions. Our results are consistent with those achieved by Chao et al, 22 Radford et al, 53 and Guanche et al, 14 who observed major differences in the behavior of knees undergoing single-bundle and doublebundle reconstruction compared to the knee with an intact ACL. On the other hand, Miura et al 67 recently reproduced knee strength similar to that of the intact ACL.…”

Section: Dislocation and Rigiditysupporting

confidence: 93%

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Anterior Cruciate Ligament Reconstruction With Double Bundle Versus Single Bundle: Experimental Study

Albuquerque

Sasaki

Amatuzzi

et al. 2007

Clinics

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Mota e Albuquerque RF, Sasaki SU, Amatuzzi MM, Angelini, FJ. Anterior cruciate ligament reconstruction with double bundle versus single bundle: experimental study. Clinics. 2007;62(3):335-44. OBJECTIVE:To test an intra-articular reconstruction of the anterior cruciate ligament of the knee in 10 human cadavers by replacing 2 anterior cruciate ligament bundles, with the purpose of producing a surrogate that would be structurally more similar to the anatomy of the anterior cruciate ligament and would provide the knee with more stability. METHODS: We reconstructed the anteromedial and posterolateral bundles using a quadriceps muscle tendon graft that included a patellar bone segment. The anteromedial bundle was replaced in 10 knees (5 right and 5 left knees from different cadavers) by a quadriceps-bone tendon graft, and the anteromedial and posterolateral bundles were replaced in the matching pairs of these knees. In the latter, the bone segment was fixed to the tibia, and the tendinous portion of the graft was divided longitudinally creating two 5-mm wide bundles that were inserted individually into the femur through 2 independent bone tunnels. Then, the knees were tested mechanically to evaluate the tibial anterior dislocation in relation to the femur, as well as the rigidity of the graft. The control group was formed by the knees with intact anterior cruciate ligaments, before being resected to be reconstructed. RESULTS:The results obtained did not show superiority of double-bundle reconstruction over single-bundle reconstruction, and neither technique provided the knee with the same stability and rigidity of the intact anterior cruciate ligament. CONCLUSION: Our hypothesis, based on the anatomy and biomechanics of the knee, that reconstruction of the anterior cruciate ligament using 2 bundles would result in a more anatomic reconstruction and provide better containment of the anterior tibial translation was not supported by the results of this study.

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Section: Dislocation and Rigiditysupporting

confidence: 93%

“…Also, there were no differences concerning rigidity between the two groups. Chao et al 22 and Guanche et al, 14 studying human knees, and Radford et al, 53 studying animals, had similar results; however, Guanche et al…”

Section: Dislocation and Rigiditymentioning

confidence: 87%

Anterior Cruciate Ligament Reconstruction With Double Bundle Versus Single Bundle: Experimental Study

Albuquerque

Sasaki

Amatuzzi

et al. 2007

Clinics

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“…In a follow-up study using an in vivo sheep model and the same technique, however, they reported increased anterior tibial translational laxity compared to normal for both techniques and the double bundle ACL reconstruction group displayed more femoral condyle articular cartilage degeneration than the single bundle ACL reconstruction group at 6 months following surgery [92]. They concluded that clinical use of double bundle ACL reconstruction was not indicated based on study results and on the increased surgical complexity.…”

Section: Double Bundle Acl Biomechanicsmentioning

confidence: 99%

Anatomic double bundle ACL reconstruction: a literature review

Crawford

Nyland

Landes

et al. 2007

Knee Surg Sports Traumatol Arthr

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With the abundance of anatomic double bundle ACL reconstruction techniques that currently exist and limited patient outcome data, one has to ask whether or not they should be used and if so, which one, and what is the learning curve for the average knee surgeon to become competent with the technique that they select? The purpose of this literature review is to summarize existing anatomic double bundle ACL reconstruction surgical and rehabilitation techniques and the clinical and biomechanical study evidence that currently exists. In choosing to perform anatomic double bundle ACL reconstruction we suggest that the knee surgeon should look for evidence of: (1) control of the pivot shift phenomenon, (2) improved transverse plane rotatory knee control during the performance of sports type movements, (3) a decreased likelihood of revision procedures either for ACL reconstruction or for treatment of associated primary or recurrent meniscal injuries, (4) improved patient self-reports of perceived function, satisfaction, and quality of life, and (5) radiographic evidence of a lower incidence and/or magnitude of osteoarthritic changes compared to conventional single bundle ACL reconstruction.

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“…In both species the ACL comprises two major bundles: the anteromedial and posterolateral [6,7]. Similar to human patients [8,9], disruption of the ovine ACL increases anterior tibial translation of the femorotibial joint [10] and osteoarthritis (OA) subsequently develops [1].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, in animal studies detailed invasive biological and biomechanical analyses may be performed which are not possible in human subjects. However, knowledge of the normal ovine ACL, and more specifically the load sharing and physical interaction between the two main bundles of this structure, is currently limited [10,17]. This relationship must be better understood in order to create DB reconstructions in this animal which are functionally similar to the intact native ACL.…”

Section: Introductionmentioning

confidence: 99%