Yulei Liu1, Guoqing Cui1, Hui Yan1, Yuping Yang1, Yingfang Ao2. 1. Institute of Sports Medicine, Peking University Third Hospital, Beijing, China. 2. Institute of Sports Medicine, Peking University Third Hospital, Beijing, China yingfang.ao@vip.sina.com.
Abstract
BACKGROUND: Whether double-bundle (DB) anterior cruciate ligament (ACL) reconstruction with 6- to 8-stranded hamstring autograft (HG) is better than single-bundle (SB) ACL reconstruction remains debatable, as long-term follow-up data are lacking. PURPOSE: To prospectively investigate and compare the long-term results of DB and SB ACL reconstruction with a 6- to 8-stranded HG. STUDY DESIGN: Randomized controlled clinical trial; LEVEL OF EVIDENCE: 1. METHODS: A total of 80 patients with chronic ACL rupture were randomized to SB or DB ACL reconstruction with a 6- to 8-stranded HG. In the SB group, both the semitendinosus tendon (ST) and the gracilis tendon (GT) were prepared in 3 or 4 strands, with a total of 6 to 8 strands. In the DB group, the ST was prepared in 3 or 4 strands used for the anteromedial bundle, and the GT was prepared in the same manner for the posterolateral bundle. Each graft was fixed with an EndoButton, a bioabsorbable interference screw, and a staple. Outcome assessment was performed by a blinded independent observer using International Knee Documentation Committee (IKDC), Tegner, and Lysholm scores, as well as range of motion (ROM), Lachman test, pivot-shift test, KT-2000 arthrometer side-to-side difference, and return-to-sport data. RESULTS: A total of 68 patients (DB group, 34; SB group, 34) were observed for a mean of 80 months (range, 74-86 months). There were 2 traumatic instability failures and two 5° extension restrictions in the DB group, while no failures or 5° extension restrictions were observed in the SB group. The mean Lysholm, Tegner, and IKDC scores improved significantly in both groups compared with preoperation scores (P < .05). No patient had a positive Lachman test result. No significant differences were found between groups in functional scores, incidence of pivot shift, ROM, Lachman test, KT-2000 arthrometer anterior laxity, or time and level of return to sport. CONCLUSION: Both SB and DB ACL reconstruction with 6- to 8-stranded HG showed satisfactory results in subjective scores and anteroposterior and rotational stability over a nearly 7-year follow-up; neither technique was superior.
RCT Entities:
BACKGROUND: Whether double-bundle (DB) anterior cruciate ligament (ACL) reconstruction with 6- to 8-stranded hamstring autograft (HG) is better than single-bundle (SB) ACL reconstruction remains debatable, as long-term follow-up data are lacking. PURPOSE: To prospectively investigate and compare the long-term results of DB and SB ACL reconstruction with a 6- to 8-stranded HG. STUDY DESIGN: Randomized controlled clinical trial; LEVEL OF EVIDENCE: 1. METHODS: A total of 80 patients with chronic ACL rupture were randomized to SB or DB ACL reconstruction with a 6- to 8-stranded HG. In the SB group, both the semitendinosus tendon (ST) and the gracilis tendon (GT) were prepared in 3 or 4 strands, with a total of 6 to 8 strands. In the DB group, the ST was prepared in 3 or 4 strands used for the anteromedial bundle, and the GT was prepared in the same manner for the posterolateral bundle. Each graft was fixed with an EndoButton, a bioabsorbable interference screw, and a staple. Outcome assessment was performed by a blinded independent observer using International Knee Documentation Committee (IKDC), Tegner, and Lysholm scores, as well as range of motion (ROM), Lachman test, pivot-shift test, KT-2000 arthrometer side-to-side difference, and return-to-sport data. RESULTS: A total of 68 patients (DB group, 34; SB group, 34) were observed for a mean of 80 months (range, 74-86 months). There were 2 traumatic instability failures and two 5° extension restrictions in the DB group, while no failures or 5° extension restrictions were observed in the SB group. The mean Lysholm, Tegner, and IKDC scores improved significantly in both groups compared with preoperation scores (P < .05). No patient had a positive Lachman test result. No significant differences were found between groups in functional scores, incidence of pivot shift, ROM, Lachman test, KT-2000 arthrometer anterior laxity, or time and level of return to sport. CONCLUSION: Both SB and DB ACL reconstruction with 6- to 8-stranded HG showed satisfactory results in subjective scores and anteroposterior and rotational stability over a nearly 7-year follow-up; neither technique was superior.
Authors: Philipp Minzlaff; Thomas Heidt; Matthias J Feucht; Johannes E Plath; Stefan Hinterwimmer; Andreas B Imhoff; Tim Saier Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-06-26 Impact factor: 4.342
Authors: Mohammed S Alomari; Abdullah A Ghaddaf; Ahmed S Abdulhamid; Mohammed S Alshehri; Mujeeb Ashraf; Hatem H Alharbi Journal: Indian J Orthop Date: 2022-08-29 Impact factor: 1.033
Authors: Matthew W DeFazio; Emily J Curry; Michael J Gustin; David C Sing; Hussein Abdul-Rassoul; Richard Ma; Freddie Fu; Xinning Li Journal: Orthop J Sports Med Date: 2020-12-15
Authors: Cooper B Ehlers; Andrew J Curley; Nathan P Fackler; Arjun Minhas; Ariel N Rodriguez; Kory Pasko; Edward S Chang Journal: Orthop J Sports Med Date: 2021-12-20
Authors: Gustavo Vinagre; Nicholas I Kennedy; Jorge Chahla; Mark E Cinque; Zaamin B Hussain; Morten L Olesen; Robert F LaPrade Journal: Arthrosc Tech Date: 2017-11-06