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

Abstract

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.

Single bundle vs double bundle for anterior cruciate ligament reconstruction evaluated with T2 mapping: A case series

“…Chen et al included studies of ACL reconstruction with the minimum of 3-year follow-up with the result of double-bundle ACL reconstruction improved knee rotational stability effectively with higher subjective functional scores compared to single-bundle techniques at the mid-term follow-up [8] . Several meta-analyses also produced similar results, that DB ACL reconstruction was superior in terms of knee kinematics restoration, especially anterior-posterior laxity [9] , significantly lower the incidence of graft failure [4] , improved also objective function and knee stability used as revision procedure regardless the primary techniques of reconstruction [ [9] , [10] ]. However, Dong et al failed to show the superiority of double-bundle with the result there was no statistically significant difference in double-bundle and single-bundle ACL reconstruction [3] .…”

Equivalent outcomes of ACL revision with over-the-top single and double-bundle reconstruction using hamstring tendon compared to anatomical single and double-bundle reconstruction

“…Preoperative planning for revision ACLR involves the evaluation of the primary bone tunnel, selection of single or second stage, selection of the graft tendon to be used, and the method of reconstruction [ 2 , 6 , 10 , 11 , 18 , 19 , 22 ]. Preoperative bone tunnel evaluation can be most accurately assessed with 3D-CT, and the decision to use a bone tunnel can be made preoperatively [ 9 ].…”

“…In terms of revision single or double bundle, Jiang et al reported two bundles of revision ACLR with an average Lysholm score of 87.3 points and an average difference of 2.0 mm between the affected and healthy sides in tibial anterior translation using the KT-2000 at a postoperative follow-up of more than 2 years [ 10 ]. Zantop et al reported that all patients showed less than 2.0 mm in double bundle revision ACLR at 2 years postoperatively [ 23 ], and Usman et al reported an average difference of 0.6 mm in tibial anterior translation at 1 year postoperatively in single revision ACLR [ 18 ].…”

Effects of graft preconditioning on γ‑irradiated deep frozen tendon allografts used in anterior cruciate ligament reconstruction

“…Arthroscopic anterior cruciate ligament (ACL) reconstruction has become a primary method for the treatment of ACL rupture ( 1 ). There are numerous factors that may influence the success of ACL reconstruction, including graft selection, the choice of surgical technique ( 2 ), bone tunnel location, graft fixation method and rehabilitation protocol.…”

“…There are numerous factors that may influence the success of ACL reconstruction, including graft selection, the choice of surgical technique ( 2 ), bone tunnel location, graft fixation method and rehabilitation protocol. Biomechanical properties of soft tissue grafts, represented by the levels of viscoelasticity, serve a role in determining the long-term results ( 1 ). Tendon grafts used in ACL reconstruction relax and elongate due to viscoelasticity, which may result in a postoperative decrease in the graft tension ( 3 ).…”