PURPOSE: The ideal treatment for patients presenting with bilateral anterior cruciate ligament (ACL) deficiency remains controversial. The purpose was to evaluate cost and functional results after one-stage bilateral ACL reconstruction using either hamstring or patella tendon autograft. METHODS: This prospective comparative study was compared the mid-term outcome of 7 patients (14 knees) who had one-stage bilateral ACL reconstruction with that of a matched group of patients who had unilateral reconstruction (21 patients). RESULTS: The median length of hospital stay was 4 (3-5) nights for the bilateral group and 2 (1-4) nights for the control group. The duration of rehabilitation process in patients from control group with unilateral ACL reconstruction was one week shorter (9 vs 8 weeks). In the bilateral group, the median Lysholm score was 96 (85-100), and in the control group, the median score was 93 (81-100). The median time to return to full-time work and to full sports was 9 weeks and 7 months for the one-stage group and 8 weeks and 6 months for the unilateral group. Six patients (86%) in the bilateral group and 17 patients (81%) in the control group were still performing at their pre-injury level of activity. National Health Institution saved 2925 EUR when we performed one-stage bilateral reconstruction instead of two-stage ACL reconstruction. CONCLUSIONS: Mid-term clinical results suggested that one-stage bilateral ACL reconstruction using either hamstring or patella tendon autograft is clinically effective. For patients presenting bilateral ACL-deficient knees, one-stage bilateral ACL reconstruction is reproducible, cost effective and does not compromise functional results. LEVEL OF EVIDENCE: II.
PURPOSE: The ideal treatment for patients presenting with bilateral anterior cruciate ligament (ACL) deficiency remains controversial. The purpose was to evaluate cost and functional results after one-stage bilateral ACL reconstruction using either hamstring or patella tendon autograft. METHODS: This prospective comparative study was compared the mid-term outcome of 7 patients (14 knees) who had one-stage bilateral ACL reconstruction with that of a matched group of patients who had unilateral reconstruction (21 patients). RESULTS: The median length of hospital stay was 4 (3-5) nights for the bilateral group and 2 (1-4) nights for the control group. The duration of rehabilitation process in patients from control group with unilateral ACL reconstruction was one week shorter (9 vs 8 weeks). In the bilateral group, the median Lysholm score was 96 (85-100), and in the control group, the median score was 93 (81-100). The median time to return to full-time work and to full sports was 9 weeks and 7 months for the one-stage group and 8 weeks and 6 months for the unilateral group. Six patients (86%) in the bilateral group and 17 patients (81%) in the control group were still performing at their pre-injury level of activity. National Health Institution saved 2925 EUR when we performed one-stage bilateral reconstruction instead of two-stage ACL reconstruction. CONCLUSIONS: Mid-term clinical results suggested that one-stage bilateral ACL reconstruction using either hamstring or patella tendon autograft is clinically effective. For patients presenting bilateral ACL-deficient knees, one-stage bilateral ACL reconstruction is reproducible, cost effective and does not compromise functional results. LEVEL OF EVIDENCE: II.
Authors: R Kevin Flynn; Cheryl L Pedersen; Trevor B Birmingham; Alexandra Kirkley; Dianne Jackowski; Peter J Fowler Journal: Am J Sports Med Date: 2005-01 Impact factor: 6.202