Anatomic single-bundle versus anatomic double-bundle anterior cruciate ligament reconstruction | ||
| The Egyptian Orthopaedic Journal | ||
| Volume 53, Issue 4, October 2018, Pages 331-340 PDF (3.29 M) | ||
| DOI: 10.4103/eoj.eoj_69_18 | ||
| Authors | ||
| Mohamed S. Kassem; Bahaa A. Motawea; Awad A. Rafalla | ||
| Abstract | ||
| Introduction Reconstruction of the torn anterior cruciate ligament (ACL) is a common surgical procedure for orthopedic surgeons, especially who are interested in sports medicine. The nonanatomical conventional single-bundle reconstructive procedures fail to recreate the native anatomy of the knee. As a result of suboptimal outcomes following traditional single-bundle ACL reconstruction, there has been a growing interest in anatomic ACL reconstruction. Aim of the study The aim of the study was to compare the midterm clinical results of arthroscopic single-bundle versus double-bundle anatomical anterior cruciate reconstruction using hamstring tendons. Patients and methods From October 2006 to May 2010, arthroscopic anatomic ACL reconstruction was carried out on 152 patients with ACL, who were divided into two equal groups: group A included 76 patients who underwent arthroscopic anatomic single-bundle ACL reconstruction, and group B included 76 patients who underwent arthroscopic anatomic double-bundle ACL reconstruction. Results All patients were analyzed using the International Knee Documentation Committee evaluation form. At the end of follow-up period, which ranged from 5 to 7 years, with an average of 5.2 years (midterm follow up), the results of group A were rated as normal and nearly normal on the total subjective and objective levels in 65 (85%) patients, except in 11 (15%) patients, who were rated abnormal and severely abnormal, whereas the results of group B were rated as normal and nearly normal on the total subjective and objective levels in 69 (91%) patients, except in seven (9%) patients, who were rated abnormal and severely abnormal. The difference in the results between the two groups was statistically not significant. Regarding the complications, there have been four cases of superficial infection related to the medial wound of tendon harvest, one in group A and three in group B, which were treated with oral antibiotics with clearance of infection. Conclusion Our results have showed that the anatomical double-bundle ACL reconstruction technique can achieve better anteroposterior and rotational stability compared with the anatomical single-bundle ACL reconstruction, which is not statistically significant. Considering that the double-bundle technique is more complex, expensive, and lengthy, we recommend the single-bundle anatomical technique as the standard technique, and the double-bundle technique to be used in case of high-demand patients like elite athletes. | ||
| Keywords | ||
| Anatomical; Anterior cruciate ligament; double bundle; single bundle | ||
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