A Prospective Randomized Study Comparing Double- and Single-Bundle Techniques for Anterior Cruciate Ligament Reconstruction

Ahldén, Mattias; Sernert, Ninni; Karlsson, Jón; Kartus, Jüri

doi:10.1177/0363546513497926

Cited by 67 publications

(74 citation statements)

References 42 publications

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“…However, in a randomized study, Ahldén et al 21 recently reported no significant differences in clinical and functional outcome when comparing single-and double-bundle ACL reconstructions. The introduction of the anatomic ACL reconstruction concept and drilling the femoral tunnel through the medial portal is most probably the reason why there has been a shift from transfixation devices to cortical fixation devices on the femoral side.…”

mentioning

confidence: 96%

Results From the Swedish National Anterior Cruciate Ligament Register

Kvist

Kartus

Karlsson

et al. 2014

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Purpose: The purpose of the study was to report baseline variables and clinical outcome for almost 24,000 patients entered into the Swedish national ACL register. Methods:The register consists of two parts; one section in which surgeons report baseline and surgical data and one section in which patients report the Knee injury and Osteoarthritis Outcome Score (KOOS) and the EQ-5D before and one, two and five years after surgery.Results: By December 2012, 23,744 patients had been entered in the surgeons' part of the register. The female/male ratio in the register is 42/58. The mean age at primary ACL reconstruction was 26 (SD 11) and 28 (SD 9) years for the female and male patients respectively. The ACL injury occurred during soccer in 36% of the females and 49% of the males. In 2012, 95% of the primary ACL reconstructions were hamstring tendon autografts.For patients who had a minimum of five years of follow-up, the revision rate was 3.3% and the contralateral reconstruction rate was 3.8%. On all follow-up occasions up to five years, the patients who had undergone revision had a significantly (p<0.001) poorer outcome than those undergoing primary unilateral ACL reconstructions in all KOOS and EQ-5D dimensions.On all follow-up occasions, smokers obtained significantly poorer scores than non-smokers in terms of both the KOOS (p<0.008) and the EQ-5D scores (p<0.024). 3Conclusion: Soccer is the most common cause of injury in both females and males, patients undergoing revisions fare less well than those undergoing primary unilateral ACL reconstructions and smokers fare less well than non-smokers. The cumulative risk of an ACL revision or contralateral ACL reconstruction during a five-year period is approximately 7%.For patients under the age of 19 years, the cumulative risk is significantly higher.Level of Evidence: Level II, Lesser-quality prospective study 4

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confidence: 96%

Results From the Swedish National Anterior Cruciate Ligament Register

Kvist

Kartus

Karlsson

et al. 2014

Arthroscopy: The Journal of Arthroscopic & Related Surgery

Self Cite

209

176

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“…However, recent studies have shown that central anatomical singlebundle ACL reconstruction can also restore normal knee function. [3][4][5] Several clinical studies have been performed which compare the single-bundle and double-bundle techniques but these have given conflicting results. 1,3,5,6 Restoration of normal biomechanical function is the primary goal of ACL reconstruction.…”

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confidence: 99%

Clinical outcomes of second-look arthroscopic evaluation after anterior cruciate ligament augmentation

Nakamae

Ochi

Deie

et al. 2014

The Bone & Joint Journal

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We report the clinical outcome and findings at second-look arthroscopy of 216 patients (mean age 25 years (11 to 58)) who underwent anterior cruciate ligament (ACL) reconstruction or augmentation. There were 73 single-bundle ACL augmentations (44 female, 29 male), 82 double-bundle ACL reconstructions (35 female, 47 male), and 61 single-bundle ACL reconstructions (34 female, 27 male). In 94 of the 216 patients, proprioceptive function of the knee was evaluated before and 12 months after surgery using the threshold to detect passive motion test. Second-look arthroscopy showed significantly better synovial coverage of the graft in the augmentation group (good: 60 (82%), fair: 10 (14%), poor: 3 (4%)) than in the other groups (p = 0.039). The mean side-to-side difference measured with a KT-2000 arthrometer was 0.4 mm (-3.3 to 2.9) in the augmentation group, 0.9 mm (-3.2 to 3.5) in the double-bundle group, and 1.3 mm (-2.7 to 3.9) in the single-bundle group: the result differed significantly between the augmentation and single-bundle groups (p = 0 .013). No significant difference in the Lysholm score or pivot-shift test was seen between the three groups (p = 0.09 and 0.65, respectively). In patients with good synovial coverage, three of the four measurements used revealed significant improvement in proprioceptive function (p = 0.177, 0.020, 0.034, and 0.026). We conclude that ACL augmentation is a reasonable treatment option for patients with favourable ACL remnants.

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“…As per previous studies, ACL reconstructions led to better clinical [2,10,16,24,28,38,40] and knee stability outcomes [1,5,7,19,20], but preoperative information on ACL anatomy is an essential prerequisite in determining optimal graft choice and restoring native ACL anatomy.…”

Section: Fig 3 Percentage Of the Length Of Tibial Acl Insertion Sitementioning

confidence: 74%

Tibial ACL insertion site length: correlation between preoperative MRI and intra-operative measurements

Widhalm

Sürer

Kurapati

et al. 2014

Knee Surg Sports Traumatol Arthrosc

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A Prospective Randomized Study Comparing Double- and Single-Bundle Techniques for Anterior Cruciate Ligament Reconstruction

Cited by 67 publications

References 42 publications

Results From the Swedish National Anterior Cruciate Ligament Register

Results From the Swedish National Anterior Cruciate Ligament Register

Clinical outcomes of second-look arthroscopic evaluation after anterior cruciate ligament augmentation

Tibial ACL insertion site length: correlation between preoperative MRI and intra-operative measurements

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