Double-bundle versus single-bundle anterior cruciate ligament reconstruction: randomized clinical and magnetic resonance imaging study with 2-year follow-up
| Autor: | Antti Paakkala, Pekka Kannus, Piia Suomalainen, Timo Järvelä, Anna-Stina Moisala |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male medicine.medical_specialty Anterior cruciate ligament reconstruction medicine.medical_treatment Anterior cruciate ligament Physical Therapy Sports Therapy and Rehabilitation Physical examination law.invention Tendons Arthroscopy Young Adult Randomized controlled trial law medicine Humans Orthopedics and Sports Medicine Prospective Studies Prospective cohort study medicine.diagnostic_test Anterior Cruciate Ligament Reconstruction Arthrometry Articular business.industry Magnetic resonance imaging Magnetic Resonance Imaging medicine.anatomical_structure Treatment Outcome Orthopedic surgery Female Nuclear medicine business Hamstring |
| Zdroj: | The American journal of sports medicine. 39(8) |
| ISSN: | 1552-3365 |
| Popis: | Background One aspect of the debate over the reconstruction of the anterior cruciate ligament is whether it should be carried out with the single-bundle or double-bundle technique. Hypothesis The double-bundle technique results in fewer graft failures than the single-bundle technique in anterior cruciate ligament reconstruction. Study Design Randomized controlled trial; Level of evidence, 1. Methods A total of 153 patients were prospectively randomized into 2 groups of anterior cruciate ligament reconstruction with hamstring autografts using aperture interference screw fixation: single-bundle technique (SB group, n = 78) and double-bundle technique (DB group, n = 75). The evaluation methods were clinical examination, KT-1000 arthrometric measurement, the International Knee Documentation Committee (IKDC) and the Lysholm knee scores, and magnetic resonance imaging (MRI) evaluation. All of the operations were performed by 1 experienced orthopaedic surgeon, and all clinical assessments were made by 2 blinded and independent examiners. A musculoskeletal radiologist blinded to the clinical data made the MRI interpretation. Results There were no differences between the study groups preoperatively. Ninety percent of patients (n = 138) were available at a minimum 2-year follow-up (range, 24-37 months). Eight patients (7 in the SB group and 1 in the DB group) had graft failure during the follow-up and had anterior cruciate ligament revision surgery ( P = .04). In addition, 7 patients (5 in the SB group and 2 in the DB group) had an invisible graft on the MRI assessment at the 2-year follow-up. Also, the anteromedial bundle was partially invisible in 2 patients and the posterolateral bundle in 9 patients. Together, the total number of failures and invisible grafts were significantly higher in the SB group (12 patients, 15%) than the DB group (3 patients, 4%) ( P = .024). No significant group differences were found in the knee scores or stability evaluations at the follow-up. Conclusion This 2-year randomized trial showed that the revision rate of the anterior cruciate ligament reconstruction was significantly lower with the double-bundle technique than that with the single-bundle technique. However, additional years of follow-up are needed to reveal the long-term results. |
| Databáze: | OpenAIRE |
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