Reconstruction of the anterior cruciate ligament: a clinical comparison of bone-patellar tendon-bone single bundle versus semitendinosus and gracilis double bundle technique

Abstract

The study hypothesis was that the outcome of semitendinosus gracilis double bundle (STG-DB) anterior cruciate ligament (ACL) reconstruction is advantageous in terms of clinical results and restoration of anterior-posterior and rotational laxity in comparison to bone-patellar tendonbone single-bundle (PTB-SB) ACL reconstruction. We analysed 41 PTB-SB and 51 STG-DB patients using the Tegner, IKDC and WOMAC scores preoperatively and at a minimum follow-up of two years. At follow-up, there was no significant difference in the clinical scores. The KT 1000 side-to-side measurement showed no significant difference between groups. The STG-DB group was significantly superior in terms of the pivot-shift sign and anterior knee pain. We conclude that the outcome of STG-DB reconstruction in the mid-term was not advantageous in terms of clinical scores and anterior-posterior laxity evaluated by the KT 1000. Nevertheless, the restored rotational laxity measured by the pivot shift test was significantly superior in the STG-DB technique.

No Difference in Revision Rates Between Single- and Double-Bundle Anterior Cruciate Ligament Reconstruction: A Comparative Study of 16,791 Patients From the Swedish National Knee Ligament Register

“…[18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] However, at least 2 randomized clinical studies have reported a lower risk of graft failure with double-bundle ACL reconstruction. [6][7][8] Many important factors, such as the timing of the operation, fixation methods, and other details in the surgical technique, vary in all of the studies.…”

An international survey on anterior cruciate ligament reconstruction practices

“…By using two separate grafts, both the anteromedial and the posterolateral bundles can be restored, providing good stability throughout the entire range of motion. Specifically, rotational stability is better restored by means of this technique than by a single bundle graft [22,25,26]. On the other hand, double-bundle reconstructions are more difficult to perform and require longer operative time.…”

A novel tool for objective assessment of femorotibial rotation: a cadaver study

“…For the clinical evaluation of the AP translation the Lachman test [11,12] is commonly used, whereas the pivot shift test is adequate for the evaluation of rotational instability [13][14][15]. Regarding an objective assessment of RS, recent studies have presented valuable approaches with the most recent exemplary work of Lorach et al [16][17][18].…”