We conducted a prospective randomised study of anatomical single-bundle (A-SB group) versus double-bundle (A-DB group) anterior cruciate ligament (ACL) reconstruction using the hamstrings tendons. Twenty patients with unilateral ACL deficiency were randomised into two groups. We created the bone tunnels at the position of the original insertion of the anteromedial bundle footprint and posterolateral bundle footprint in the A-DB group and at the central position between these two bundles in the A-SB group. All of the patients were tested before ACL reconstruction and one year after surgery. The KT-1000 measurements, isokinetic muscle peak torque and heel-height difference were evaluated and the general knee condition was assessed by Lysholm score. For pre- and postoperative stability assessment, we used the six-degrees-of-freedom of knee kinematic measurement system using an electromagnetic device (the EMS) for quantitative assessment during the Lachman test and the pivot shift test. There were no significant differences in the KT-1000 measurements, isokinetic muscle peak torque, heel-height difference, and Lysholm score at one-year follow-up between these two groups. The EMS data showed there were significant differences in the acceleration of the pivot shift test between the operated knee and the contralateral normal knees in the A-SB group. In conclusion, clinical outcomes were equally good in both groups. However, the EMS data showed the anatomical double-bundle ACL reconstruction tended to be biomechanically superior to the single-bundle reconstruction.

The aim of this study is to investigate and compare the three dimensional bending angle of the graft at the femoral tunnel aperture in the transtibial and the far anteromedial portal technique. Seven fresh-frozen human cadaveric knees were used. Six degrees-of-freedom of knee kinematics and knee position data were measured using an electromagnetic device and the three dimensional bending angles of the each graft at the femoral tunnel aperture were calculated by computer simulation. Additionally, in order to assess the stress on the graft, the length change between the femoral and tibial attachment sites of the AM and PL bundle were calculated. The maximum length of each bundle was detected at full extension of the knee. The relative change of the length of the PL bundle in the range of 70 degrees -0 degrees of knee flexion was significantly larger than that of the AM bundle. (P < 0.05) Maximum graft bending angles in both techniques were obtained at full extension where the graft was fully stretched. The AM and PL graft bending angles in the transtibial technique were significantly larger than in the far anteromedial portal technique at low flexion angle (AM: 0 degrees -10 degrees , PL: 0 degrees -50 degrees ) (P < 0.01). This suggests use of the far anteromedial portal technique might result in lower stress on the graft at the femoral tunnel aperture and therefore might reduce graft damage.

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A diagnosis of IPAF might predict a favorable prognosis and less risk of AEs in patients with CFIP.

These results confirm that patients with IPF often develop pneumothorax during their clinical course and that the onset of pneumothorax predicts a poor outcome.