Prospective Clinical Comparisons of Anatomic Double-Bundle versus Single-Bundle Anterior Cruciate Ligament Reconstruction Procedures in 328 Consecutive Patients

Kondo, Eiji; Yasuda, Kazunori; Azuma, Hirotaka; Tanabe, Yoshie; Yagi, Tomonori

doi:10.1177/0363546508317123

Cited by 280 publications

(309 citation statements)

References 52 publications

(93 reference statements)

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“…[11][12][13][14][15][16] On the other hand, only a clinical report 17 has introduced a remnant-preserving technique for double-bundle ACL reconstruction, in which 2 femoral tunnels and one tibial tunnel were made, although anatomic double bundle ACL reconstruction procedures have recently attracted notice because of biomechanical advantages in laboratory studies. [18][19][20][21][22][23][24][25][26][27][28] However, no previous studies have shown clinical evidence about utility of the ACL remnant tissue preservation in ACL reconstruction as of yet. To verify whether preservation of the ACL remnant tissue can really improve proprioceptive functions and enhance revascularization, we should conduct a randomized comparative trial with a sufficient number of patients to compare the 2 ACL reconstruction procedures with and without the remnant preservation in terms of proprioception and revascularization of the graft.…”

Section: Introductionmentioning

confidence: 99%

A Pilot Study of Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction With Ligament Remnant Tissue Preservation

Yasuda

Kondo

Kitamura

et al. 2012

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Purpose: The purpose of this pilot study is to clarify the preliminary results of an anatomic double-bundle ACL reconstruction procedure with ligament remnant tissues. Methods:Using the trans-tibial technique, 2 doubled semitendinosus tendons were grafted into 4 tunnels created at the center of each bundle attachment, penetrating the ACL remnant tissue. Forty-four patients (27 men and 17 women) with an isolated ACL injury underwent ACL reconstruction using this procedure. The mean age of subjects was 29 years (range: 17-58). Postoperative clinical evaluations were performed at 16.6 months on average (range: 12 -23). Radiological evaluations were also performed to evaluate the tunnel location in the femur and the tibia. Results:The average operation time was 86 minutes (range: 72 -96) in the cases with ACL reconstruction only. Postoperatively, the mean anterior laxity was 0.7 mm. The postoperative pivot-shift test was negative in 81.8 % of the patients, while there were no patients evaluated as ++. No patients showed any extension or flexion deficit. There were no patients evaluated as "Nearly abnormal" or "Abnormal" under the IKDC evaluation. The tunnel angles of the 4 tunnels were identical to those reported in the previous study. Conclusions:The minimal 1-year clinical results of anatomic double-bundle ACL 3 reconstruction with ligament remnant tissue preservation were comparable to the previously reported results of the anatomic double-bundle reconstruction without remnant tissue preservation.

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Section: Introductionmentioning

confidence: 99%

A Pilot Study of Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction With Ligament Remnant Tissue Preservation

Yasuda

Kondo

Kitamura

et al. 2012

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…When accounting for the literature comparing singleand double-bundle ACL reconstruction, improved postoperative laxity and outcome scores for double-bundle ACL reconstruction have been reported in several in vivo studies [11,42,43]. However, other studies have shown no significant differences between these techniques [44][45][46].…”

Section: Double-bundle Acl Reconstructionmentioning

confidence: 99%

Kinematic outcomes following ACL reconstruction

Naendrup

Zlotnicki

Chao

et al. 2016

Curr Rev Musculoskelet Med

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Anterior cruciate ligament (ACL) reconstruction aims to restore the translational and rotational motion to the knee joint that is lost after injury. However, despite technical advancements, clinical outcomes are less than ideal, particularly in return to previous activity level. A major issue is the inability to standardize treatment protocols due to variations in materials and approaches used to accomplish ACL reconstruction. These include surgical techniques such as the transtibial and anteromedial portal methods that are currently under use and the wide availability of graft types that will be used to reconstruct the ACL. In addition, concomitant soft tissue injuries to the menisci and capsule are frequently present after ACL injury and, if left unaddressed, can lead to persistent instability even after the ACL has been reconstructed. Advances in the field of biomechanics that help to objectively measure motion of the knee joint may provide more precise data than current subjective clinical measurements. These technologies include extra-articular motion capture systems that measure the movement of the tibia in relation to the femur. With data gathered from these devices, a threshold for satisfactory knee stability may be established in order to correctly identify a successful reconstruction following ACL injury.

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“…Kondo et al found that double bundle reconstruction was better than non-anatomic single bundle however there was no difference compared to a laterally placed anatomical single bundle. They concluded that double bundle reconstruction may not offer a significant advantage over single bundle [38]. Ho et al showed equal kinematics using central anatomic single bundle compared to double bundle reconstruction [39].…”

Section: Biomechanical Studiesmentioning

confidence: 99%

“…Given the biomechanical advantages of performing double bundle ACL reconstruction over non-anatomic single bundle reconstruction it is not surprising that there have been numerous clinical studies comparing double and single bundle ACL reconstruction [38,[41][42][43][44][45][46][47]. Several of these reveal improved anterior and rotational stability with DB reconstruction [38,43,45,47] however many show no significant difference [42,44,46].…”

Section: Clinical Outcomesmentioning

confidence: 99%