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Double-bundle anterior cruciate ligament reconstruction is better than single-bundle reconstruction in terms of objective assessment but not in terms of subjective score

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

A comparison of clinical outcomes between double-bundle (DB) and single-bundle (SB) anterior cruciate ligament (ACL) reconstruction for patients with ACL injury.

Methods

Sixty patients were treated with either SB (n = 30) or DB (n = 30) ACL reconstruction between 2011 and 2012. The hamstring tendons were autografted with suspensory fixation on the femoral side, while a bio-absorbable interference screw was used for fixation on the tibial side. These patients were evaluated using Lysholm score, International Knee Documentation Committee (IKDC) forms (both objective and subjective), Lachman test, pivot shift test, and KT 1000 arthrometer.

Results

After a median follow-up duration of 35.5 months (ranging between 30 and 42 months), the frequency of patients who had high objective IKDC scores was significantly higher in the DB group than those in the SB group. In terms of DB, the Lachman test was normal in 26 patients (86.7%), nearly normal in three patients (10%), and abnormal in one patient (3.3%); comparatively, in terms of SB, the Lachman test was normal in 20 patients (66.7%), nearly normal in eight patients (26.7%) and abnormal in two patients (6.6%). The pivot shift test was negative in 29 patients (96.7%) and 21 patients (70%) for DB and SB, respectively. The average KT-1000 side-to-side difference was 1.0 mm for DB and 1.5 mm for SB. The subjective IKDC and Lysholm score showed non-significant differences between both techniques.

Conclusion

Double-bundle ACL reconstruction was found to have a significant advantage in anterior and rotational stability as well as objective IKDC than that of SB reconstruction. However, subjective measurements showed no statistical differences between the techniques.

Level of evidence

II.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Faculty of Medicine for Girls, Al-Zahraa University Hospital, Al-Azhar University, Cairo, Egypt

    Faisal Ahmed Hashem El-Sherief, Wael Abdelkarim Aldahshan, Yaser Elsayed Wahd, Ashraf Mohamed Abdelaziz, Hany Abdel Gawwad Soliman, Tohamy Goda Hassan, Hassan Fathy Elbehairy & Adel Hamed Awadallah

Authors
  1. Faisal Ahmed Hashem El-Sherief
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  2. Wael Abdelkarim Aldahshan
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  3. Yaser Elsayed Wahd
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  4. Ashraf Mohamed Abdelaziz
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  5. Hany Abdel Gawwad Soliman
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  6. Tohamy Goda Hassan
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  7. Hassan Fathy Elbehairy
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  8. Adel Hamed Awadallah
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Correspondence to Faisal Ahmed Hashem El-Sherief.

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The authors declare that they have no conflict of interest.

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The authors received no financial support for the research, authorship, and publication of this article.

Ethical approval

Ethical approval was obtained from the Institutional Review Board (IRB) from Al-Azhar University: No.429 and agreement.

Informed consent

Patients were informed, and they consented to conduct the study. All the patients agreement to conduct the study.

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El-Sherief, F.A.H., Aldahshan, W.A., Wahd, Y.E. et al. Double-bundle anterior cruciate ligament reconstruction is better than single-bundle reconstruction in terms of objective assessment but not in terms of subjective score. Knee Surg Sports Traumatol Arthrosc 26, 2395–2400 (2018). https://doi.org/10.1007/s00167-017-4804-3

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  • DOI: https://doi.org/10.1007/s00167-017-4804-3

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