Tunnel Enlargement After Double-Bundle Anterior Cruciate Ligament Reconstruction: A Prospective, Randomized Study

Järvelä, Timo; Moisala, Anna-Stina; Paakkala, T.; Paakkala, Antti

doi:10.1016/j.arthro.2008.07.018

Cited by 134 publications

(160 citation statements)

References 27 publications

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“…28 Nine studies with a total of 335 patients which included Lysholm score were available for comparison. 6,18,[28][29][30][31][32][33][34] Similarly subjective IKDC score was reported in seven studies with 256 patients. IKDC score in our study was found to be comparable to that in other studies.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic anatomic double bundle anterior cruciate ligament reconstruction: Our experience with follow-up of 4 years

Morey

Nag

Chowdhury

et al. 2016

Journal of Clinical Orthopaedics and Trauma

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Section: Discussionmentioning

confidence: 99%

Arthroscopic anatomic double bundle anterior cruciate ligament reconstruction: Our experience with follow-up of 4 years

Morey

Nag

Chowdhury

et al. 2016

Journal of Clinical Orthopaedics and Trauma

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“…On the other hand, many previous studies have shown an association between tunnel enlargement and worse results such as anterior and rotational instability of the knee 8 . The aim of the study is to investigate prospectively the association between grafts and bone tunnel enlargement, along with the effect of grafts on the clinical results such as the knee stability after ACL reconstruction.…”

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confidence: 96%

Tibial tunnel enlargement and joint instability after anterior cruciate ligament reconstruction. A prospective comparison between autograft and allograft

Zhang

Hao

et al. 2017

Acta Cir. Bras.

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IVTibial tunnel enlargement and joint instability after anterior cruciate ligament reconstruction. A prospective comparison between autograft and allograft 1 Abstract Purpose: To investigate tibial tunnel widening and knee instability after ACL reconstruction with hamstring autograft or irradiated soft tissue allograft. Methods: Eight-two patients were divided into two groups: autograft group and allograft group. Radiographic and clinical evaluations were performed. Results: Seventy patients were followed up with median of 36.3 months (range 36-38 months). Tibial tunnel widening was at or greater than 30% for nine patients in the autograft group and 15 patients in the allograft group (P = 0.0417). The average percentage of tibial tunnel widening was 26.7 ± 4.0 % and 29.7 ± 5.3 % in autograft and allograft groups, respectively (P = 0.0090). Knee range of motion was not affected by the reconstruction operation or different grafts. Thigh atrophy improved significantly within 24 months after ACL reconstructions in both groups. ACL reconstruction with the allograft leaded to less knee stability than that with the autograft from one year after operation (P = 0.0023). There was no significant difference between two groups with respect to Lysholm score (P = 0.1925) and Tegner score (P =0 .0918) at the final follow-up. Conclusion:The allograft group reported significantly more tibial tunnel widening and knee instability compared with the autograft group.

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“…In the two studies, all patients were recruited from Hatanpää Hospital, Tampere, Finland. Concerning patients with anterior cruciate ligament reconstruction, the study by Järvelä et al [3] carried out in 2005 included 52 single-bundle and 25 double-bundle reconstructions, and the second study by Järvelä et al [4] included 25 singlebundle and 35 double-bundle reconstructions. Therefore, the larger group of single-bundle reconstructions and the larger group of double-bundle reconstructions by Järvelä et al [3,4] should be included in this meta-analysis.…”

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confidence: 99%

“…Evidence indicated that only the larger study should be included for analysis when some publications contained the same or overlapping data. There are two studies performed by Järvelä et al [3,4] containing overlapping data. In the two studies, all patients were recruited from Hatanpää Hospital, Tampere, Finland.…”

mentioning

confidence: 99%

“…Evidence indicated that only the larger study should be included for analysis when some publications contained the same or overlapping data. There are two studies performed by Järvelä et al [3,4] Moreover, further high-quality RCTs based on larger sample sizes are still needed to compare arthroscopic single-bundle and double-bundle anterior cruciate ligament reconstructions. We believe that our remarks will contribute to more accurate elaboration of the results presented by Li et al…”

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confidence: 99%

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Comment on Li et al.: Single-bundle versus double-bundle anterior cruciate ligament reconstruction: an up-to-date meta-analysis

Dong

Chen

Fan³

et al. 2013

International Orthopaedics (SICOT)

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Dear Editor,In International Orthopaedics, Xue Li and his colleagues published a meta-analysis conducted to compare the efficacy of arthroscopic single-bundle and double-bundle anterior cruciate ligament reconstruction, and they did very well [1]. However, the meta-analysis has brought a few questions to our minds that we would like to convey to the authors:1. Publication language was limited to English in the metaanalysis. Therefore, the authors should mention the potential importance of language bias in the limitations of their meta-analysis. 2. In the article, the authors used the odds ratio (OR) for dichotomous outcomes to report the risk value rather than relative risk (RR). As there are 17 randomised controlled trials (RCTs) included, RR can report the real risk value better than OR. Therefore, we suggest that RR should be used to report the risk value in this article. 3. It is not sufficient that publication bias was only assessed by visual examination of a funnel plot. Funnel plot symmetry should be further assessed by statistical tests (e.g. Egger's linear regression test or Begg's rank correlation test). Moreover, in the meta-analysis, publication bias was only assessed for KT1000 arthrometer measurements. Actually, publication bias should be assessed for other comparisons (such as Lysholm score, objective International Knee Documentation Committee score, negative pivot-shift test). Therefore, publication bias may be present, distorting the meta-analysis. 4.It is not appropriate that summary OR and standard mean difference (SMD) estimates with corresponding 95 % confidence intervals were derived by using the method of Mantel-Haenszel (M-H) or inverse variance (IV) with the assumptions of a random effects model. However, studies should be combined by using the DerSimonian and Laird random effects model, which considers both within-and between-study variations [2]. 5. The difference in the follow-up periods between studies was large, which may cause heterogeneity. Subgroup analysis was performed by stratifying the available data according to follow-up periods. To make the article more credible, the authors should analyse the effect of single-bundle versus double-bundle anterior cruciate ligament reconstruction according to different ages and sexes on account of the limitation of the studies included. Moreover, further highquality RCTs based on larger sample sizes are still needed. 6. Evidence indicated that only the larger study should be included for analysis when some publications contained the same or overlapping data. There are two studies performed by Järvelä et al. [3,4] Moreover, further high-quality RCTs based on larger sample sizes are still needed to compare arthroscopic single-bundle and double-bundle anterior cruciate ligament reconstructions. We believe that our remarks will contribute to more accurate elaboration of the results presented by Li et al.

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Tunnel Enlargement After Double-Bundle Anterior Cruciate Ligament Reconstruction: A Prospective, Randomized Study

Cited by 134 publications

References 27 publications

Arthroscopic anatomic double bundle anterior cruciate ligament reconstruction: Our experience with follow-up of 4 years

Arthroscopic anatomic double bundle anterior cruciate ligament reconstruction: Our experience with follow-up of 4 years

Tibial tunnel enlargement and joint instability after anterior cruciate ligament reconstruction. A prospective comparison between autograft and allograft

Comment on Li et al.: Single-bundle versus double-bundle anterior cruciate ligament reconstruction: an up-to-date meta-analysis

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