Arthroscopic single-bundle ACL reconstruction with modified double-layer bone-patellar tendon-bone allograft

Abstract

Therapeutic, retrospective comparative study, Level III.

Single-bundle modified patellar tendon versus double-bundle tibialis anterior allograft ACL reconstruction: a prospective randomized study

“…In comparison with previous BPTB preparation procedures such as a BPTB and gracilis tendon composite or DB BPTB graft [15, 29], the present modification of the BPTB graft was original. The BPTB allograft was modified into a column of mean 9.9 mm in diameter with wider cross‐sectional area than traditional BPTB of a rectangle with 10 mm in width and 4 mm in height [4]; significantly lesser anterior laxity and better knee function have been achieved than those of traditional BPTB ACL reconstruction [16]. After the modification, SB ACL reconstruction even achieved comparable clinical outcomes to DB reconstruction with tibialis anterior allograft in the present study.…”

“…Single‐bundle reconstruction with modified BPTB allograft has been described in a previous study [16]. The BPTB allograft was shaped into a column of 25 mm in length, 10 mm in diameter.…”

“…In our clinical practice, the rectangular bone‐patellar tendon‐bone (BPTB) allograft was modified into a round double‐layer allograft of 10 mm in diameter. With the graft size increased, significantly better outcomes in knee stability and function were achieved in comparison with traditional SB ACL reconstruction [16], but the outcome of comparison with the DB technique is unknown.…”

Better 4-year outcomes for anterior cruciate ligament reconstruction with double-layer versus single-layer bone-patellar tendon-bone allografts

“…Doubling the cross‐sectional area of the monolayer BPTB resulted in better anterior stability compared with the single‐layer BPTB. Also, the DBPTB allograft eliminated “dead space” [10] and therefore the “windshield wiper” effect [18], factors that are thought to interfere with tendon‐to‐bone healing and that lead to post‐operative bone tunnel enlargement [11, 17, 18]. Consequently, the DBPTB patients achieved better clinical results than those receiving the traditional BPTB allograft.…”

“…In a 2‐year retrospective clinical study, Kang et al [11] reported that the double‐layer bone‐patellar tendon‐bone (DBPTB) allograft significantly improved anterior stability and function of the knee. To the best of the authors’ knowledge, there have been no prospective studies of DBPTB grafts; therefore, the present study was designed to evaluate the clinical outcomes of DBPTB grafting for ACL reconstruction.…”