Prospective Randomized Study of Objective and Subjective Clinical Results Between Double-Bundle and Single-Bundle Anterior Cruciate Ligament Reconstruction

Sasaki, Shizuka; Tsuda, Eiichi; Hiraga, Yasuharu; Yamamoto, Yuji; Maeda, Shugo; Sasaki, Eiji; Ishibashi, Yasuyuki

doi:10.1177/0363546515624471

Cited by 57 publications

(71 citation statements)

References 52 publications

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“…Additionally, height and IED on the coronal radiograph also predicted GD comprehensively with slightly improved accuracy ( R 2 : from 0.207 to 0.224). According to the multiple regression model and our criteria for additional harvesting GT, 40 (1) height <150 cm, (2) female sex, and (3) patients aged ≥30 years were at risk of having a GL <230 cm, whereas patients who (1) have an IED <70 mm and (2) are <150 cm in height were also at risk of having a GD <5.0 mm.…”

Section: Discussionmentioning

confidence: 99%

Anthropometric and Skeletal Parameters Predict 2-Strand Semitendinosus Tendon Size in Double-Bundle Anterior Cruciate Ligament Reconstruction

Chiba

Tsuda

Sasaki

et al. 2017

Orthopaedic Journal of Sports Medicine

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Background:Few studies have examined whether skeletal parameters predict hamstring graft size during anterior cruciate ligament reconstruction (ACLR).Purpose/Hypothesis:The purpose of this study was to examine whether preoperative anthropometric and radiographic skeletal parameters could predict hamstring graft size during ACLR. We hypothesized that both anthropometric and skeletal parameters can be used to predict graft size in our double-bundle procedure and that the use of skeletal parameters will improve the accuracy of graft size prediction.Study Design:Cross-sectional study; Level of evidence, 3.Methods:A total of 200 patients were recruited and underwent double-bundle ACLR using a semitendinosus (ST) graft. The harvested tendon was measured to determine graft length (GL) and then split at its midpoint. The graft diameters of the anteromedial (GDAM) and posterolateral bundles (GDPL) were measured at the femoral aspect of the 2-stranded graft. The mean diameters of both bundles were included in the analysis. On the coronal radiograph, femorotibial angle (FTA), femoral interepicondylar distance (IED), and tibial plateau width (coronal tibial width [CTW]) were measured. Blumensaat line length (BLL) and the lateral tibial width (LTW) were measured on the lateral radiograph. A linear regression analysis was conducted using graft size as the dependent variable and age, sex, height, weight, Tegner activity score, and skeletal parameters as the independent variables.Results:Mean GL was 258.9 ± 21.9 mm, GDAM was 5.9 ± 0.5 mm, and GDPL was 5.7 ± 0.6 mm. Single regression analysis showed that GL was significantly predicted by sex, height, weight, Tegner activity score, IED, CTW, BLL, and LTW (R 2 range, 0.033-0.342). GD was predicted by sex, height, weight, IED, CTW, BLL, and LTW (R 2 range, 0.094-0.207). Stepwise multiple linear regression analysis significantly confirmed sex, height, and age as the variables to comprehensively predict GL (R 2 = 0.384). With regard to GD, stepwise multiple regression confirmed height and IED as significant variables (R 2 = 0.224).Conclusion:Both preoperative anthropometric and radiographic parameters on plain radiographs were able to predict harvested GL and 2-strand GD. Multivariate regression slightly improved the prediction of graft dimensions compared with univariate regression.

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Section: Discussionmentioning

confidence: 99%

Anthropometric and Skeletal Parameters Predict 2-Strand Semitendinosus Tendon Size in Double-Bundle Anterior Cruciate Ligament Reconstruction

Chiba

Tsuda

Sasaki

et al. 2017

Orthopaedic Journal of Sports Medicine

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“…1 In their prospective randomized controlled study (RCT), Sasaki et al reported there was no significant difference in objective or subjective outcomes between anatomical DB ACLR with an HT graft and anatomical rectangular tunnel single-bundle ACLR with a BPTB graft at 24-month follow-up. 25 Although this RCT could be considered a very high-level study, the author's use of different tibial fixation methods may have influenced the results of their study. In addition, their study lacked quantitative evaluation of femoral and tibial tunnel locations.…”

Section: Discussionmentioning

confidence: 99%

“…There are very few previous studies that have compared BPTB and HT grafts in anatomical ACLR using either the lateral intercondylar ridge as an index or with validation of tunnel positions. 25 In our institution, we have performed anatomical ACLR with BPTB and HT grafts using the same methods since 2012 including anatomical concept, fixation device, initial graft tension, or postoperative rehabilitation protocol.…”

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confidence: 99%

Bone-Patellar Tendon-Bone Autograft versus Hamstring Tendon Autograft for Anatomical Anterior Cruciate Ligament Reconstruction with Three-Dimensional Validation of Femoral and Tibial Tunnel Positions

et al. 2017

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The purpose of this retrospective study was to first compare the clinical outcome of anatomical double-bundle (DB) anterior cruciate ligament reconstruction (ACLR) with hamstring tendon (HT) autografts and anatomical rectangular tunnel ACLR with bone-patellar tendon-bone (BPTB) autografts. Secondly, we aimed to demonstrate the quantitative locations of the femoral and tibial tunnel apertures using postoperative three-dimensional computed tomography (3D CT). Twenty-five patients underwent anatomical rectangular tunnel ACLR using BPTB grafts (Group B) and 23 patients underwent anatomical DB ACLR using HT grafts (Group H). All patients underwent subjective postoperative evaluations using the Lysholm score and Knee Injury and Osteoarthritis Outcome Score. Patients also underwent objective evaluations by the International Knee Documentation Committee score, the Lachman test, the pivot-shift test, and range of motion. In addition, we quantitatively assessed anterior knee stability using a KneeLax3 arthrometer and thigh strength. All evaluations except for thigh strength were assessed for a minimum 2 years of follow-up period. Femoral and tibial tunnel aperture locations were quantitatively evaluated postoperatively using 3D CT images in all patients. BPTB grafts showed significantly better anterior knee stability than HT grafts (0.1 mm versus 1.1 mm, = 0.01), although there were no significant differences in other objective and all subjective evaluations between the two graft types. Morphometric analysis of femoral and tibial tunnel locations revealed that the two procedures were based on the same anatomical concept. In conclusion, BPTB grafts showed significantly better anterior knee stability than HT grafts, although no significant differences in other objective evaluations and all subjective evaluations were detected between the two graft types in anatomical ACLR. Additional 3D CT data validated the anatomical concepts of these two procedures.

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“…2,3 In the midterm, several studies presented clinical outcomes without being able to detect significant differences between the DB and SB technique in subjective and objective outcome measures. 4,5 Some studies claimed more rotational stability for DB ACL-R, 5-7 but systematic reviews failed to prove significant differences when comparing SB and DB ACL-R outcomes. 6,8 Often, only functional aspects were described in high-quality studies; in particular, knee stability or laxity after ACL-R was regarded as the primary endpoint.…”

Section: See Related Article On Page 996mentioning

confidence: 99%

Editorial Commentary: No Difference in Knee Osteoarthritis After Single-Bundle Versus Double-Bundle Anterior Cruciate Ligament Reconstruction

Mayr

Stoehr

2019

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Prospective Randomized Study of Objective and Subjective Clinical Results Between Double-Bundle and Single-Bundle Anterior Cruciate Ligament Reconstruction

Cited by 57 publications

References 52 publications

Anthropometric and Skeletal Parameters Predict 2-Strand Semitendinosus Tendon Size in Double-Bundle Anterior Cruciate Ligament Reconstruction

Anthropometric and Skeletal Parameters Predict 2-Strand Semitendinosus Tendon Size in Double-Bundle Anterior Cruciate Ligament Reconstruction

Bone-Patellar Tendon-Bone Autograft versus Hamstring Tendon Autograft for Anatomical Anterior Cruciate Ligament Reconstruction with Three-Dimensional Validation of Femoral and Tibial Tunnel Positions

Editorial Commentary: No Difference in Knee Osteoarthritis After Single-Bundle Versus Double-Bundle Anterior Cruciate Ligament Reconstruction

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