Author/Editor     Hussein, Mohsen; Van Eck, Carola F.; Čretnik, Andrej; Dinevski, Dejan; Fu, Freddie H.
Title     Individualized anterior cruciate ligament surgery
Type     članek
Vol. and No.     Letnik 40, št. 8
Publication year     2012
Volume     str. 1781-1788
ISSN     0363-5465 - The American journal of sports medicine
Language     eng
Abstract     Background: Reconstruction of the anterior cruciate ligament (ACL) has become a commonly performed procedure. However, biomechanical studies have demonstrated that conventional single-bundle ACL reconstruction techniques are only successful in limiting anterior tibial translation but less effective for restoring rotatory laxity. Purpose: This study aimed to compare the results of single- and double-bundle ACL reconstruction using an anatomic technique, individualized based on the patient's native ACL size. The authors hypothesized that there would be no difference between the results of anatomic single-bundle (ASB) and anatomic double-bundle (ADB) reconstruction when the surgical technique is individualized. Study design: Cohort study; Level of evidence, 2. Methods: Depending on intraoperative measurements of theACL insertion site size, patients were selected for either ASB (n = 32) or ADB (n = 69) ACL reconstruction. In all groups, hamstring tendons autograft was used with suspensory fixation on the femoral side and bioabsorbable interference screw fixation on the tibial side. The outcomes were evaluated by an independent blinded observer using the Lysholm score, subjective International Knee Documentation Committee (IKDC) form, KT-1000 arthrometer for anteroposterior stability, and pivot-shift test for rotational stability. The average follow-up was 30 months (range, 26-34 months). There were no statistically significant differences in the baseline demographics of the 2 groups. Results: There was no significant difference between the ADB and ASB groups for Lysholm score (93.9 vs 93.5), subjective IKDC score (93.3 vs 93.1),anterior tibial translation (1.5- vs 1.6-mm side-to-side difference), and pivot shift (92% vs 90% with negative pivot-shift examination). Conclusion: Anatomic double-bundle reconstruction is not superior to anatomic single-bundle reconstruction when an individualized ACL reconstruction technique is used.
Descriptors     Anterior Cruciate Ligament Reconstruction
Sprednja križna vez, rekonstrukcija
Surgical Procedures, Operative
Kirurški postopki, operativni
Surgery
Rehabilitation
Treatment Outcome
Kirurgija
Rehabilitacija
Izid zdravljenja
Methods
Metode
Keywords     anatomic technique
single bundle
double bundle
individualization