A prospective comparative study of clinical and functional outcomes between anatomic double bundle and single bundle hamstring grafts for arthroscopic anterior cruciate ligament reconstruction

Morey, Vivek Machhindra; Nag, Hira Lal; Chowdhury, Buddhadev; Sankineani, Sukesh Rao; Naranje, Sameer

doi:10.1016/j.ijsu.2015.07.699

Cited by 20 publications

(28 citation statements)

References 35 publications

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“…Sufficient biomechanical strength and better clinical results concerning these grafts have been reported. 3,8,48,54,68,92,96 In addition, the quadriceps autograft is another choice of autograft. 3,36 It has been reported that the quadriceps autograft has the same level of strength with similarly good clinical results and without severe complications.…”

Section: Discussionmentioning

confidence: 99%

Systematic Review of Surgical Technique and Tunnel Target Points and Placement in Anatomical Single-Bundle ACL Reconstruction

Iriuchishima¹,

Goto²

2020

J Knee Surg

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The purpose of this systematic review was to reveal the trend in surgical technique and tunnel targets points and placement in anatomical single-bundle anterior cruciate ligament (ACL) reconstruction. Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement, data collection was performed. PubMed, EMBASE, and Cochran Review were searched using the terms “anterior cruciate ligament reconstruction,” “anatomic or anatomical,” and “single bundle.” Studies were included when they reported clinical results, surgical technique, and/or tunnel placement evaluation. Laboratory studies, technical reports, case reports, and reviews were excluded from this study. From these full article reviews, graft selection, method of creating the femoral tunnel, and femoral and tibial tunnel target points and placement were evaluated. In the 79 studies included for data evaluation, the selected grafts were: bone patella tendon bone autograft (12%), and hamstring autograft (83%). The reported methods of creating the femoral tunnel were: transportal technique (54%), outside-in technique (15%), and transtibial technique (19%). In the 60 studies reporting tunnel target points, the target point was the center of the femoral footprint (60%), and the center of the anteromedial bundle footprint (22%). In the 23 studies evaluating tunnel placement, the femoral tunnel was placed in a shallow–deep direction (32.3%) and in a high–low direction (30.2%), and the tibial tunnel was placed from the anterior margin of the tibia (38.1%). The results of this systematic review revealed a trend in anatomical single-bundle ACL reconstruction favoring a hamstring tendon with a transportal technique, and a tunnel target point mainly at the center of the ACL footprint. The level of evidence stated is Systematic review of level-III studies.

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Section: Discussionmentioning

confidence: 99%

Systematic Review of Surgical Technique and Tunnel Target Points and Placement in Anatomical Single-Bundle ACL Reconstruction

Iriuchishima¹,

Goto²

2020

J Knee Surg

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“…Arthroscopic techniques have been successfully applied in many clinical disciplines ( 43 , 44 ). In terms of joint surgery, arthroscopy has been widely used in the shoulder, elbow, wrist, hip, knee, ankle and other joints ( 45 – 50 ), especially in applications in the knee joint, and the technology has progressed ( 51 – 57 ). As a result, arthroscopic techniques were selected to develop the present model, due a series of advantages.…”

Section: Discussionmentioning

confidence: 99%

A model of anterior cruciate ligament injury in cynomolgus monkeys developed via arthroscopic surgery

Zhang

Guan

et al. 2018

Exp Ther Med

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The anterior cruciate ligament (ACL) is an important structure that maintains the stability of knee joints. Animal models of ACL injury are helpful to explore its underlying mechanisms, and strategies for prevention, treatment and rehabilitation. Therefore, the aim of the present study was to develop an efficient model of ACL injury in cynomolgus monkeys via arthroscopic techniques. In the present study, 18 cynomolgus monkeys were randomly divided into a model group (n=6), a sham operation group (n=6) and a blank control group (n=6). One-quarter of the ACL was removed under arthroscopy in the model group. In the sham operation group, only arthroscopic exploration was performed as a control. In the blank control group, monkeys were housed under the same conditions for the same length of time. Magnetic resonance imaging examination was performed pre- and post-operatively, as well as measurements of the circumference of the thigh and calf, and of the maximum flexion degree of the knee. Anterior drawer test, Lachman test and pivot-shift tests were also performed. The results revealed that the injured side of the knees in the model group became unstable, as determined from evaluation of the physical tests. In conclusion, based on these findings, the modeling method of ACL injury was effective, and may contribute to the associated research concerning ACL injury.

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“…Although revision ACL reconstruction is promising, the outcome is generally inferior to that of successful primary ACL reconstruction (9,26). Despite double-bundle ACL reconstruction producing superior clinical outcomes to those of single-bundle ACL reconstruction (16)(17)(18)(19)(20)(21)(22)(23)(24), the double-bundle technique has rarely been used in revision ACL reconstruction due to it being technically more challenging (27). Tunnel placement errors, particularly femoral tunnel misplacement, are the most common causes for primary graft failure (28).…”

Section: Discussionmentioning

confidence: 99%

“…Compared with single-bundle ACL reconstruction, the double-bundle technique produced better Lachman and pivot-shift test results, KT arthrometry results and Tegner score after 3-12 years post operation (19). In most cases, double-bundle ACL reconstruction yielded significantly favorable results on KT arthrometry, pivot shift test and Lachman test (16)(17)(18)(19)(20)(21)(22)(23)(24), as well as reduced graft failure (22)(23)(24) and improved International Knee Documentation Committee (IKDC) objective score (18,23,24) compared with single-bundle ACL reconstruction. Therefore, double-bundle ACL reconstruction is indicated to be superior to single-bundle ACL reconstruction.…”

Section: Introductionmentioning

confidence: 96%

“…Consequently, inferior outcomes to primary ACL reconstructions were reported, although significant improvements have been demonstrated after revision reconstruction (10)(11)(12)(13)(14). Of note, most revision ACL constructions were performed using a single-bundle technique (15); however, a vast amount of evidence has demonstrated that the double-bundle technique is superior to the single-bundle technique for primary ACL reconstruction (16)(17)(18)(19)(20)(21)(22)(23)(24). Compared with single-bundle ACL reconstruction, the double-bundle technique produced better Lachman and pivot-shift test results, KT arthrometry results and Tegner score after 3-12 years post operation (19).…”

Section: Introductionmentioning

confidence: 99%

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Double-bundle revision anterior cruciate ligament reconstruction is effective in rescuing failed primary reconstruction and re-introducing patients to physical exercise

Jiang

Chen

et al. 2017

Exp Ther Med

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Abstract. The anterior cruciate ligament (ACL) is one of a pair of cruciate ligaments in the human knee and is critical for knee stability, as it limits anterior tibial translation on the femur, restrains rotation and resists varus and valgus joint forces. The present study aimed to assess the effect of double-bundle revision anterior cruciate ligament (ACL) reconstruction in improving the subjective and objective functions and re-introducing patients to physical activity after primary ACL reconstruction had failed. A total of 34 patients who underwent double-bundle ACL revision surgeries were included in the present retrospective study. Lysholm, Tegner and IKDC scores as well as KT-2000 arthrometry measures were obtained pre-and post-operatively. The follow-up time was at least 2 years. The results indicated that the IKDC, Lysholm and Tegner scores as well as KT-2000 flexion scores were significantly improved after revision ACL reconstruction. All patients resumed to performing physical exercise activities after revision surgeries, 65% of whom reached pre-injury levels. In conclusion, these results demonstrated that double-bundle revision ACL reconstruction was consistently effective in rescuing failed primary ACL reconstruction and re-introducing patients to physical exercise.

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A prospective comparative study of clinical and functional outcomes between anatomic double bundle and single bundle hamstring grafts for arthroscopic anterior cruciate ligament reconstruction

Abstract: We suggest that functional outcome and clinical stability may be better with anatomical double bundle anterior cruciate ligament reconstruction as compared to anatomical single bundle anterior cruciate ligament reconstruction.

Cited by 20 publications

References 35 publications

Systematic Review of Surgical Technique and Tunnel Target Points and Placement in Anatomical Single-Bundle ACL Reconstruction

Systematic Review of Surgical Technique and Tunnel Target Points and Placement in Anatomical Single-Bundle ACL Reconstruction

A model of anterior cruciate ligament injury in cynomolgus monkeys developed via arthroscopic surgery

Double-bundle revision anterior cruciate ligament reconstruction is effective in rescuing failed primary reconstruction and re-introducing patients to physical exercise

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