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Functional double-bundle anterior cruciate ligament reconstruction using hamstring tendon autografts with preserved insertions is an effective treatment for tibiofemoral instability

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The aim of this study was to introduce a modified anatomical anterior cruciate ligament reconstruction using functional double bundles (F-DBACLR), which achieved sequential tensioning at all flexion angles postoperatively, and compare its clinical outcomes with the anatomical single-bundle technique (A-SBACLR).

Methods

A total of 156 patients with an ACL injury underwent ACLR (A-SB group, n = 78; F-DB group, n = 78). All operations were performed by anatomically identifying the ACL footprints and fixing the graft at a pre-determined degree of knee flexion. Two observers blinded to the patient identities examined the patients preoperatively and during follow-up (median 28.2 months; range 26–31 months). Multiple subjective and objective clinical evaluation tests and assessment of clinical outcomes concerning the translational and rotational stability of the knee including the International Knee Documentation Committee (IKDC) questionnaire, Lysholm Knee Scoring Scale, Knee Injury and Osteoarthritis Outcome Score (KOOS), Tegner Activity Scale, KT-1000 laxity measurements, Lachman test and pivot-shift test were performed preoperatively and postoperatively.

Results

Preoperatively, no differences were found between the two groups. During the 2-year observation period, patients in the F-DB group revealed better clinical outcomes in terms of the Tegner Activity Scale Score, IKDC, KOOS and Lysholm Knee Scoring Scale. Similar results were shown in regard to the translational stability in both groups, while the F-DB group had more rotational stability at 2 years of follow-up.

Conclusions

The clinical outcomes indicated that F-DBACLR is clinically practicable and advantageous in the treatment of the ACL-deficient knee.

Level of evidence

II.

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Funding

The study was supported by Beijing Nova Program (Z161100004916137).

Author information

Author notes

  1. Qiang Zhang and Yimeng Yang contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopedics, The General Hospital of Chinese People’s Liberation Army, 28 Fuxing Road, Haidian District, Beijing, 100853, China

    Qiang Zhang, Yimeng Yang, Ji Li, Hao Zhang, Yangmu Fu & Yan Wang

  2. Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China

    Yimeng Yang

  3. Department of Orthopaedic Surgery, Royal Liverpool University Hospital, Prescot Street, Liverpool, UK

    Qiang Zhang

Authors
  1. Qiang Zhang
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Correspondence to Qiang Zhang or Yan Wang.

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The authors report that they have no conflicts of interest in the authorship and publication of this article.

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This study received ethics approval from the Chinese People’s Liberation Army General Hospital Institutional Review Board (IRB) under the reference number (2013/136).

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Zhang, Q., Yang, Y., Li, J. et al. Functional double-bundle anterior cruciate ligament reconstruction using hamstring tendon autografts with preserved insertions is an effective treatment for tibiofemoral instability. Knee Surg Sports Traumatol Arthrosc 27, 3471–3480 (2019). https://doi.org/10.1007/s00167-019-05401-w

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  • DOI: https://doi.org/10.1007/s00167-019-05401-w

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