Rectangular Tunnel Double-Bundle Anterior Cruciate Ligament Reconstruction with Bone–Patellar Tendon–Bone Graft to Mimic Natural Fiber Arrangement

Shino, Konsei; Nakata, Ken; Nakamura, Norimasa; Toritsuka, Yukiyoshi; Horibe, Shuji; Nakagawa, Shigeto; Suzuki, Toshiya

doi:10.1016/j.arthro.2008.06.010

Cited by 146 publications

(135 citation statements)

References 8 publications

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“…For more successful reconstruction of the ACL, the ideal outcome would be restoration of the anatomy of the ACL, which means functional restoration of the ACL to its native dimensions, collagen orientation, and insertion sites to achieve better stability [8]. Many different techniques have been suggested for anatomic ACLR using different tunnels positions, fixation systems, and types of graft [16,28,37,39]. A number of studies have been conducted to compare postoperative stability and function after anatomic DB and SB ACLR.…”

Section: Discussionmentioning

confidence: 99%

“…Average diameter of femoral tunnel in the SB group was 9 mm and the length of the tunnel was 40 mm. The tibial tunnel was then prepared in an anatomic position at the ligament's footprint using an endoscopic aimer adjusted to a 45°position in the coronal plane (Smith and Nephew tibial guide) [9,20,39]. The alignment on the sagittal plane should be at 70°with respect to the medial plateau [9,20,39].…”

Section: Methodsmentioning

confidence: 99%

“…After checking the proper positioning at 10 o'clock for the right knee, a 4.5-mm cannulated drill was used to create the femoral tunnel and with the specific instrument and the length of the tunnel was measured (Smith & Nephew Endoscopy, Andover, MA) [9,20,39]. Once the required graft size was assessed, the half tunnel was prepared using a drill and dilators to obtain a tunnel 0.5 mm in diameter smaller than the graft to have a good press-fit and avoid possible movement of the graft.…”

Section: Methodsmentioning

confidence: 99%

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Single- versus Double-bundle ACL Reconstruction: Is There Any Difference in Stability and Function at 3-year Followup?

Gobbi¹,

Mahajan²,

Karnatzikos³

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Despite a number of studies comparing postoperative stability and function after anatomic doublebundle and single-bundle anterior cruciate ligament reconstruction (ACLR), it remains unclear whether double-bundle reconstruction improves stability or function. Questions/purposes We therefore asked whether patients having single-and double-bundle ACLR using semitendinosus (ST) alone differed with regard to (1) postoperative stability; (2) ROM; and (3) five functional scores. Methods We prospectively followed 60 patients with an isolated anterior cruciate ligament (ACL) injury. Thirty patients underwent single-bundle and 30 patients underwent double-bundle ACL reconstruction. Clinically we assessed stability and range of motion (ROM); anteroposterior stability was assessed by Rolimeter and rotational stability by a pivot shift test. Function was assessed by IKDC, Noyes, Lysholm, Marx, and Tegner activity scales.The minimum followup was 36 months (mean, 46.2 months; range, 36-60 months). Results Residual anteroposterior laxity at 3 years postoperatively was similar in both groups: 1.4 ± 0.3 mm versus 1.4 ± 0.2 mm, respectively. We observed no difference in the pivot shift test. ROM was similar in both groups, although double-bundle patients required more physical therapy sessions to gain full ROM. IKDC, Noyes, Lysholm, Marx, and Tegner scores were similar at final followup. Conclusion Double-bundle reconstruction of the ACL did not improve function or stability compared with singlebundle reconstruction.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Single- versus Double-bundle ACL Reconstruction: Is There Any Difference in Stability and Function at 3-year Followup?

Gobbi¹,

Mahajan²,

Karnatzikos³

et al. 2012

Clinical Orthopaedics &Amp; Related Research

Self Cite

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“…Another approach would be to create a different portal, such as a transpatellar portal. Some surgeons use a 70-degree arthroscope femoral insertion site from the anteromedial portal, which provides a better view [8,[10][11][12][13]. However, for surgeons utilizing the transtibial technique for ACL reconstruction, the improved view of the femoral insertion site via the anterolateral portal afforded by the 45-degree arthroscope should be especially helpful for properly angling the drill so as to optimally direct the tibial tunnel towards the femoral attachment.…”

Section: Discussionmentioning

confidence: 99%

The 45-Degree Arthroscope Improves Visualization of the Femoral Attachment of the Anterior Cruciate Ligament

Okazaki¹,

Matsuda²,

Tashiro³

et al. 2012

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Background: Exposure of the insertion site of the anterior cruciate ligament (ACL) is important for appropriate tunnel placement in ACL reconstruction surgery. However, observing the femoral ACL insertion site via the standard anterolateral portal is sometimes difficult. In this study, we compared views of the femoral ACL insertion site between 30-degree and the 45-degree arthroscopes. Methods: We first inserted the 30-degree and the 45-degree arthroscope into the anterolateral portal of a knee simulator in which we had drawn a lattice pattern on the lateral intercondylar notch based on the quadrant method. Next, we compared the arthroscopic views provided by the 30-degree and 45-degree arthroscopes during ACL reconstruction surgery by measuring the area of the lateral intercondylar notch visible through each of the arthroscopes. Results: In the knee simulator, the 45-degree arthroscope showed the entire area of the lateral intercondylar notch, whereas the 30-degree arthroscope had to be introduced more deeply to show the most superior and posterior quadrant, where the attachment of the anteromedial bundle of ACL is located. During the ACL reconstruction, the area of the lateral intercondylar notch in the field of view was larger through the 45-degree arthroscope than through the 30-degree arthroscope. Conclusion: The 45-degree arthroscope provides a better view of the femoral ACL insertion site via the anterolateral portal, which may be helpful during ACL reconstruction.

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“…The basis for this technique is to drill the femoral tunnel in the center of the femoral foot print, between the centers of both bundles, behind the intercondylar ridge, in such way that it includes part of both AMB and PLB fibers (Ho et al, 2009;Shino et al, 2008, Steiner, 2009van Eck et al, 2011;Yamamoto et al, 2004).…”

Section: The Anatomic Single Bundle Acl Reconstructionmentioning

confidence: 99%

Contemporary Anterior Cruciate Ligament Reconstruction

Christel¹,

Boueri²

2011

Modern Arthroscopy

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Rectangular Tunnel Double-Bundle Anterior Cruciate Ligament Reconstruction with Bone–Patellar Tendon–Bone Graft to Mimic Natural Fiber Arrangement

Cited by 146 publications

References 8 publications

Single- versus Double-bundle ACL Reconstruction: Is There Any Difference in Stability and Function at 3-year Followup?

Single- versus Double-bundle ACL Reconstruction: Is There Any Difference in Stability and Function at 3-year Followup?

The 45-Degree Arthroscope Improves Visualization of the Femoral Attachment of the Anterior Cruciate Ligament

Contemporary Anterior Cruciate Ligament Reconstruction

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