A Comparison between Clinical Results of Selective Bundle and Double Bundle Anterior Cruciate Ligament Reconstruction

Yoo, Yon Sik; Song, Si Young; Yang, Cheol Jung; Ha, Jong Mun; Kim, Yoon Sang; Seo, Young Jin

doi:10.3349/ymj.2016.57.5.1199

Cited by 8 publications

(3 citation statements)

References 31 publications

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“…Selective-bundle ACL reconstruction for partial tears has gained interest in the past several years. [14][15][16][17][18][19][20][21][22][23][24][25] However, clinical examination, MRI, and routine arthroscopic evaluation may not be able to provide a detailed and proper assessment of the integrity of the ACL. 11,12 As a result, determining which partial ACL tears truly involve only a single bundle continues to be a challenge.…”

Section: Discussionmentioning

confidence: 99%

The Push-Through Sign—Making the Decision for Selective-Bundle Anterior Cruciate Ligament Surgery

Bartolozzi¹,

Jog²,

Smith³

2020

Arthroscopy Techniques

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Partial anterior cruciate ligament (ACL) tears are often difficult to diagnose and treat. Recent interest in the literature has focused on performing selective-bundle ACL reconstruction in patients with symptomatic partial ACL tears when one of the ACL bundles is intact. However, the clinical examination, magnetic resonance imaging, and arthroscopic evaluation of partial ACL tears may not correlate, and proper assessment of the integrity of the intact portion of the ACL continues to be a challenge. If a selective-bundle ACL reconstruction is performed in a patient with an apparently intact but structurally damaged individual bundle, the outcome would be compromised by leaving the damaged bundle in place. This technical note provides a description of a simple and reliable arthroscopic method to aid in the diagnosis of a partial ACL tear. The use of this method to assess remaining ligamentous tissue will assist surgeons in deciding for or against selective-bundle ACL reconstruction.

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Section: Discussionmentioning

confidence: 99%

The Push-Through Sign—Making the Decision for Selective-Bundle Anterior Cruciate Ligament Surgery

Bartolozzi¹,

Jog²,

Smith³

2020

Arthroscopy Techniques

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“…The AM bundle is under tension in flexion, while the PL bundle is under tension during extension (15). ACL reconstruction with preserved remnant ligament in the case of selective AM or PL bundle tear offers comparable clinical results to double bundle reconstruction (16). ACL tear may accompany an injury of the meniscus or cartilage and can lead to osteoarthritis (17).…”

Section: Discussionmentioning

confidence: 99%

Intra-articular and meniscal pathology according to anterior cruciate ligament injury pattern: both-bundle tear or selective bundle tear

Park

Lee

et al. 2019

Acta Radiol

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Background Articular cartilage injury and meniscal tear are usually combined with anterior cruciate ligament injury. Purpose We investigated the incidence of cartilage injury and traumatic meniscal tear according to the type of combined anterior cruciate ligament tear (both-bundle versus selective bundle tear). Material and Methods This retrospective study included 103 patients diagnosed with anterior cruciate ligament tear after knee joint magnetic resonance imaging and who underwent knee joint arthroscopy. Two radiologists evaluated articular cartilage injuries and meniscal tear independently. We used the chi-square test to analyze the association between type of anterior cruciate ligament bundle tear and presence of cartilage or meniscal injury in each reader. Results Cartilage injury presented a significantly higher prevalence in both-bundle tear than did selective bundle tear in reader 1 ( P = 0.004). In reader 2, both-bundle tear had a tendency for higher risk of cartilage injury, but this was not statistically significant ( P = 0.178). In meniscal injury, there was a statistically significant increase in the risk of associated meniscal injury in both-bundle tear versus selective bundle anterior cruciate ligament injury ( P = 0.019 and 0.021). The risk of accompanying traumatic meniscal lesion was significantly higher in both-bundle tear ( P = 0.036 and 0.018). Conclusion The incidence of accompanying meniscal injury, especially traumatic tears, is higher in both-bundle anterior cruciate ligament tear than in selective bundle tear. There was no significant difference in incidence of cartilage injury between both-bundle tear and selective bundle tear, although one of two readers showed a higher incidence in both-bundle tear.

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“…With the development of minimally invasive concepts and continuous advancements in arthroscopic technology, arthroscopic ACL reconstruction has become the main treatment for this traumatic injury. Although the overall clinical results as well as patient reported outcome measurements (PROMs) after ACL reconstruction are generally good (1)(2)(3), some patients fail to achieve satisfactory results and may require a second revision surgery (4)(5)(6). Thus, increasing the success rate of ACL reconstruction surgery is a hot topic in sports medicine at home and abroad.…”

Section: Introductionmentioning

confidence: 99%

Changes in local bone mineral density can guide the treatment plan for patients with rupture of the anterior cruciate ligament

Liu

et al. 2021

Ann Palliat Med

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Background: Many factors affect the outcomes of anterior cruciate ligament (ACL) reconstruction surgery.However, few studies have examined the effects of local bone conditions on the reconstruction of the ACL.This study investigated the changes in the local bone mineral density (BMD) of the knee after rupture of the ACL with the view of using this information to guide treatment options.Methods: Patients with ACL rupture treated in our department from January 2017 to April 2019 were enrolled in this study. Prior to surgery, local BMD measurements were obtained from all patients and used to determine the appropriate method of ligament fixation. If the local BMD of the affected knee was not significantly lower than that of the healthy side, extrusion fixation was conducted. If the BMD was significantly lower than that of the healthy knee, suspension fixation was applied. The conditions of tunnel cutting or screw splitting, and tunnel enlargement or screw pull-out were observed during the surgery. The post-surgical function of the knee joint was evaluated regularly by physical examination, imaging data, the IKDC scale score, and the Lysholm score.Results: A total of 80 patients with unilateral ACL rupture were included. There were 64 males and 16 females. Decreased BMD was observed in the affected knee compared to the healthy knee for 68 patients.Patients with an ACL history of more than 3 months had lower BMD compared to patients with a history of less than 3 months. Tunnel enlargement and screw pull-out occurred in 2 patients, screw splitting occurred in 1 patient. The fixation mode was adjusted in real-time during the surgery for 3 patients. All patients were followed up for at least 12 months (mean 20.65±5.12 months). The IKDC score increased from 43.07±2.66 pre-surgery to 89.17±3.28 at the final follow-up, and similarly, the Lysholm score increased from 43.49±2.38 pre-surgery to 89.67±2.97 post-surgery. Conclusions:The measurement of local BMD before surgery may play a significant role in guiding the type of graft fixation. It is recommended that patients undergo surgical reconstruction within 3 months after injury.

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A Comparison between Clinical Results of Selective Bundle and Double Bundle Anterior Cruciate Ligament Reconstruction

Cited by 8 publications

References 31 publications

The Push-Through Sign—Making the Decision for Selective-Bundle Anterior Cruciate Ligament Surgery

The Push-Through Sign—Making the Decision for Selective-Bundle Anterior Cruciate Ligament Surgery

Intra-articular and meniscal pathology according to anterior cruciate ligament injury pattern: both-bundle tear or selective bundle tear

Changes in local bone mineral density can guide the treatment plan for patients with rupture of the anterior cruciate ligament

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