No difference was found between double-bundle and single-bundle anterior cruciate ligament reconstructions in terms of osteoarthritis at 15-year follow-up.

Autor: Seppänen A; Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland., Kiekara T; Medical Imaging Center, Tampere University Hospital, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland., Suomalainen P; Head of Tampere University Hospital Orthopaedics Trauma Unit, Tampere, Finland., Mäenpää H; Department of Orthopaedics, Tampere University Hospital, Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland., Huhtala H; Faculty of Social Sciences, Tampere University, Tampere, Finland., Järvelä T; Sports Medicine and Arthroscopic Center, Hospital Mehiläinen, Tampere, Finland.
Jazyk: angličtina
Zdroj: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA [Knee Surg Sports Traumatol Arthrosc] 2024 Nov; Vol. 32 (11), pp. 2770-2779. Date of Electronic Publication: 2024 May 31.
DOI: 10.1002/ksa.12304
Abstrakt: Purpose: The purpose of the study was to determine whether the grade of osteoarthritis (OA) is higher with single-bundle (SB) or double-bundle (DB) anterior cruciate ligament (ACL) reconstruction. The hypothesis was that there will be no difference in the grade of OA between the techniques.
Methods: This study was a randomised controlled trial (RCT) with a follow-up period of 15 years. Patients were randomly assigned to either the SB group (n = 78) or the DB group (n = 75). Surgical techniques were anatomic, and the rehabilitation protocol was standardised. Evaluation included Kellgren-Lawrence (KL) difference and absolute OA results. OA was defined as a KL grade of at least 2.
Results: At 15-year follow-up, information was available on 101 patients (66%), of whom 56 (37%) were accepted in the final statistical analysis. No difference was found between the SB and DB techniques in terms of KL difference or absolute OA results. Significantly less OA was found in the contralateral knee (21%) than in the reconstructed knee (59%) (p < 0.001). Patients with meniscal tears who underwent partial meniscal resection during ACL reconstruction had a significantly higher rate of OA changes (82%) compared with patients with isolated ACL tears (33%) (p < 0.001). A longer delay between initial injury and surgery did not appear to affect the severity of the KL classification.
Conclusion: At 15-year follow-up, no difference was found between the DB and SB techniques in terms of OA.
Level of Evidence: Level I.
(© 2024 The Author(s). Knee Surgery, Sports Traumatology, Arthroscopy published by John Wiley & Sons Ltd on behalf of European Society of Sports Traumatology, Knee Surgery and Arthroscopy.)
Databáze: MEDLINE
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