Double-Bundle Versus Single-Bundle Anterior Cruciate Ligament Reconstruction: A Prospective Randomized Study With 10-Year Results

Järvelä, Sally; Kiekara, Tommi; Suomalainen, Piia; Järvelä, Timo

doi:10.1177/0363546517712231

Cited by 85 publications

(134 citation statements)

References 47 publications

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“…Patellofemoral joint OA after ACL reconstruction has been mostly unrecognized. 17,18 In recent studies, Yoon et al 19 and Jarvela et al 3 showed that the reconstruction technique has only a small effect on OA progression, so our finding is in line with the previous finding. We also found that ACL reconstruction has little effect on contralateral patellofemoral joint OA progression.…”

Section: Discussionsupporting

confidence: 91%

“…3,9 Table 5 shows that revision ACL reconstruction due to complete tear of ACL graft was higher in group DB than in group SB, while revision ACL reconstruction due to instability was higher in group SB than in group DB. This is in accordance with many recent papers 3,[20][21][22] that the patients who undergo DB ACL reconstruction may have some advantages in knee kinematics. Because the two grafts cross each other inside the joint, acting separately at different knee angles, they mimic the normal ACL anatomy more closely than a single graft.…”

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confidence: 99%

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Eight-year results of transtibial nonanatomic single-bundle versus double-bundle anterior cruciate ligament reconstruction: Clinical, radiologic outcomes and survivorship

Yoon

Kim

Park

et al. 2019

J Orthop Surg (Hong Kong)

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To compare the long term outcomes of transtibial nonanatomic single-bundle (SB) and double-bundle (DB) anterior cruciate ligament (ACL) reconstruction. Methods: Between January 2008 and September 2010, we retrospectively evaluated 377 patients who underwent primary ACL reconstruction and who were available at 8 years of follow-up. Patients who received transtibial nonanatomic SB ACL reconstruction (n ¼ 263) were assigned to group SB and DB ACL reconstruction (n ¼ 114) to group DB. The patients were assessed with the International Knee Documentation Committee (IKDC), the Lysholm scores, Tegner activity score, knee joint stability tests, and patellofemoral osteoarthritis (OA) findings using the Kellgren-Lawrence (K-L) classification. Contralateral ACL (CACL) injury was also evaluated. Results: Thirteen patients underwent revision ACL surgery during the follow-up. Ultimately, 256 patients in group SB and 108 patients in group DB were available at the 8-year follow-up. At final follow-up, the IKDC subjective score (p ¼ 0.04) and Lysholm score (p ¼ 0.02) showed significantly superior results in group DB compared to group SB. However, there was no significant difference of Tegner activity score (p ¼ 0.30), range of motion (p ¼ 0.81), and knee joint stability tests. There was significant progression of patellofemoral OA between preoperative and final follow-up in ipsilateral knee of both groups but not significant progression in contralateral knee. However, there was no significant difference between the two groups at the follow-up. There were 2.7% ipsilateral ACL graft failure in group SB, compared with 5.2% in group DB (p ¼ 0.12) and 6.4% CACL tear in group SB, compared with 5.2% in group DB (p ¼ 0.65). The mean survivorship of ACL graft was 9.47 + 0.05 years (95% confidence interval (CI), 9.36-9.58) in group SB and 9.87 + 0.16 years (95% CI, 9.54-10.20) in group DB, and there was no significant difference (p ¼ 0.25). Conclusion: DB ACL reconstruction resulted in significantly better clinical IKDC subjective scores and Lysholm scores. However, most of the differences in clinical scores were small, and the clinical relevance of this difference is unknown. In addition, there was no significant difference in Tegner activity score, knee joint stability tests, patellofemoral OA, and survivor rate of the ACL graft and CACL after reconstruction after a minimum of 8-year follow-up.

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Section: Discussionsupporting

confidence: 91%

mentioning

confidence: 99%

Eight-year results of transtibial nonanatomic single-bundle versus double-bundle anterior cruciate ligament reconstruction: Clinical, radiologic outcomes and survivorship

Yoon

Kim

Park

et al. 2019

J Orthop Surg (Hong Kong)

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“…8 Therefore, the current trend in anterior cruciate ligament reconstruction techniques has shifted to the anatomical double-bundle reconstruction, which involves reconstruction of both anteromedial bundle and posterolateral bundle of anterior cruciate ligament, with reported improved clinical outcomes. 10,11 Although its long-term efficacy remains controversial, the rationale of double-bundle anterior cruciate ligament reconstruction has been supported by the research data of various functional anatomical and biomechanical studies. [12][13][14][15] The canine CrCL is also composed of two bundles, the cranial part and caudal part, [16][17][18][19] like in humans.…”

Section: Introductionmentioning

confidence: 99%

Functional Anatomy of the Craniomedial and Caudolateral Bundles of the Cranial Cruciate Ligament in Beagle Dogs

Tanegashima

Edamura

Akita

et al. 2019

Vet Comp Orthop Traumatol

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Objective The aim of this study was to investigate detailed functional anatomy of the craniomedial bundle (CrMB) and caudolateral bundle (CdLB) of cranial cruciate ligament (CrCL) for application of intra-articular anatomical reconstruction in dogs. Materials and Methods Twelve stifle joint of 12 Beagle cadavers were used. Anatomical characteristics of femoral attachment regions of the CrCL were determined. Then, the location and area of the footprints of the CrMB and CdLB were objectively measured. Each bundle was equally divided into four fibre bundles, and changes in the fibre arrangement were recorded during stifle range of motion. Additionally, the tension of each fibre bundle at various stifle joint angles was objectively measured. Results The attachment region of the CrCL clearly differed from that reported in humans. The centre of the CdLB attachment site was located craniodistal to that of the CrMB on the femur and slightly caudal to that of the CrMB on the tibia. The area of the CrMB on the femoral and tibial attachment sites was larger than that of the CdLB. During stifle range of motion, each divided fibre bundle in the CrMB and CdLB was twisted intricately. The tension of the CrMB was higher than that of CdLB. The central part of the CrMB was always tense during stifle range of motion. Clinical Significance These results may contribute to the application of anatomical reconstruction surgery for CrCL deficient stifle in dogs.

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“…and SB ACL reconstruction. 18 However, 18 trials (69%) reported significantly better results with the DB technique than with the SB technique. In this study, 145 papers from 2008 to date compared the two techniques of SB and DB ACL reconstruction, and similar mid-and long-term outcomes were achieved with the SB and the DB techniques, as demonstrated by the good to optimal results in both patient groups by Mayr et al 19 However, rotational stability is a problem after ACL reconstruction 20 which has motivated surgeons to find a solution to this problem and it has been shown that the ALL on the lateral compartment of the knee is necessary for the stabilization of the rotational laxity.…”

Section: Discussionmentioning

confidence: 98%

Trends in Anterior Cruciate Ligament Reconstruction in the Last Decade: A Web-Based Analysis

Yücens

Aydemir

2018

J Knee Surg

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Anterior cruciate ligament (ACL) injury is known to be one of the most common knee joint injuries. ACL reconstruction can be similar to the native ACL in respect of graft morphology, tension, position, and orientation. ACL reconstruction can be applied with different surgery techniques, graft and fixation devices, and rehabilitation as ACL reconstruction is just as important as surgery. Although commonly known as a sports injury, ACL injuries are increasingly seen in the general population. The aim of this study was to investigate the trends in ACL injury treatment in the last decade especially the graft choice. The abstracts of a total of 2,622 papers which stated ACL in the title were investigated through a search on the Web of Knowledge. Main topics were created as the ACL reconstruction theme. ACL reconstruction was examined in the abstracts with graft choice as the main theme followed by single bundle, double bundle, sports, rehabilitation, revision, complication, skeletally immature, biomechanics and kinematics, fixation devices, meniscus, anesthesia and pain, tunnel, cell, and intra-articular injection. Of the total 2,622 documents, 2,129 were original articles and 181 were reviews. Most of the documents, 436 in number (16.6%), were published in the , followed by the, , at 264. Of the total documents published, 36.3% were from the United States followed by 8.5% from Japan. The author with the most publications was F.H. Fu with 94 publications followed by B.R. Bach with 41 publications. The hamstring graft was most used at 187 single use and comprising 52% of the total graft combinations. Most papers were published in 2016. In 2012, single and double bundle grafts were determined to a total of 23. The most common title investigated in papers was biomechanics and kinematics with a total of 241 publications followed by rehabilitation at 208. Throughout the years of the study period, the most common graft choice was hamstring autograft. Biomechanics and kinematics was the most common title investigated as biomechanics and rehabilitation are known to be just as important as surgery for a successful outcome and patient satisfaction.

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Double-Bundle Versus Single-Bundle Anterior Cruciate Ligament Reconstruction: A Prospective Randomized Study With 10-Year Results

Cited by 85 publications

References 47 publications

Eight-year results of transtibial nonanatomic single-bundle versus double-bundle anterior cruciate ligament reconstruction: Clinical, radiologic outcomes and survivorship

Eight-year results of transtibial nonanatomic single-bundle versus double-bundle anterior cruciate ligament reconstruction: Clinical, radiologic outcomes and survivorship

Functional Anatomy of the Craniomedial and Caudolateral Bundles of the Cranial Cruciate Ligament in Beagle Dogs

Trends in Anterior Cruciate Ligament Reconstruction in the Last Decade: A Web-Based Analysis

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