U-Dos Double-Bundle and Single-Bundle Allograft Anterior Cruciate Ligament Reconstruction: A Comparative Study

Abstract

Anterior cruciate ligament (ACL) injuries are very common among athletes. If these injuries are not repaired, meniscus and cartilage damage will arise, with serious consequences in the joint. Different options for ACL reconstruction have been described, aiming for anteroposterior, lateral, and rotational stability. Using single- or double-bundle grafts has been one of the most discussed topics, aiming for better rotational stability. We performed a prospective randomized study to evaluate the outcomes of ACL reconstruction using double- or single-bundle grafts for 72 patients with acute ACL injuries. Patients were blindly randomized into 2 groups of 36 knees before surgery using a blind envelope that contained the technique to be used: double-bundle U-Dos technique (DB group) or single-bundle technique (SB group). All patients had a preoperative and postoperative evaluation and were followed with the same parameters at 2, 4, 6, 12, and 24 months. Both anteroposterior and rotational stability were evaluated using a KT-1000 arthrometer (MEDmetric) and an experimental Pivot-Shift Meter (ORMEDS) device. Functional outcomes were measured using the Tegner-Lysholm scale. The DB group had fewer ACL re-tears, fewer meniscal injuries, and better Tegner-Lysholm and International Knee Documentation Committee scores. This group also had better KT-1000 and Pivot-Shift Meter values. After 2-year follow-up, the DB group had significantly better results than the SB group. [ Orthopedics . 2023;46(1):13–18.]

Peracetic acid sterilized tendon and ligament allografts for knee reconstruction

“…Allografts provide an acceptable alternative to autografts for reconstructive surgery [ 16 ]. Allografts aid in reducing graft harvest site morbidity and provide surgeons with an abundant supply of grafts [ 13 ], where the type of graft can be selected according to the patient requirements (diameter, length); however, the literature varies regarding rupture rates and on the use of allografts and autografts with no apparent differences between allografts or autograft use (1–12% for allograft and 1–13% for autograft [ 1 , 10 , 11 , 18 , 19 , 26 ]) and some reports displaying higher rerupture rates for allografts (7–26% [ 6 , 8 ]); however, in this retrospective analysis the use of chemically sterilized allografts displayed results similar to previous reports (6.6–13% for autografts and 6.5–12% for allografts, regardless of the sterilization method [ 7 , 17 , 18 , 25 ]).…”

“…Some disadvantages may include slower biological remodelling and a theoretical risk of disease transmission [ 4 ] that can be minimized by using chemically sterilized allografts. Both allografts and autografts have reported similar functional outcomes in 10-year follow-up studies [ 15 ] and in reports with shorter follow-up [ 1 , 6 – 8 , 10 , 16 – 19 ]. Allograft use is well reported for both anterior (ACL) [ 1 , 2 , 9 , 10 , 15 , 19 ] and posterior cruciate ligament (PCL) reconstruction [ 16 ].…”

Research progress of procyanidins in repairing cartilage injury after anterior cruciate ligament tear

“…The anterior cruciate ligament (ACL) serves as a vital stabilizing structure of the knee joint, preventing anterior tibial translation and internal tibial rotation. ACL tear ranks among the most frequent injuries in athletes, accounting for approximately 50% of knee ligament injuries, and is often precipitated by sudden direction changes and impacts on the knee joint [ [1] , [2] , [3] , [4] , [5] ]. Current treatment strategies primarily involve ACL repair and reconstruction [ 6 , 7 ].…”