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Radiological maturation and clinical results of double-bundle and single-bundle anterior cruciate ligament reconstruction. A 5-year prospective case-controlled trial

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The aim of the study was to make a prospective comparison of the radiological and clinical outcomes of patients undergoing single-bundle and double-bundle anterior cruciate ligament (ACL) reconstruction.

Method

This prospective, case-controlled study included 65 patients, separated into 2 groups as 33 patients undergoing single bundle (SB), and 32 patients undergoing double bundle (DB) ACL reconstruction. The patients were evaluated clinically using the International Knee Documentation Committee (IKDC) and the Lysholm knee scores. Stability was evaluated with the KT-1000 Arthrometer Measurement, the Lachman and pivot shift tests. Magnetic resonance images (MRI) at 1 and 5 years postoperatively were evaluated by a musculoskeletal radiologist. All the operations were performed by a single surgeon and the clinical evaluations were made by an independent researcher.

Results

Evaluation was made of a total of 53 patients (SB: 28, DB: 25). No statistically significant difference was determined between the groups regarding the postoperative IKDC and Lysholm scores. The pivot shift tests were negative in the DB group and positive in two patients of the SB group. The Lachman test was negative in all the patients. No significant difference was determined between the groups. No statistically significant difference was determined between the two groups in respect of the arthrometer measurements. In the SB group, revision surgery was performed in two patients due to graft failure. No graft failure findings were determined in the DB group, and no statistically significant difference was determined between the groups in respect of graft failure. On the MRIs taken at 1 year postoperatively, the ACL was seen to be hyperintense in 16 patients in the DB group and 6 patients in the SB group (p = 0.004). On the 5-year MRIs, ACL hypointensity could not be seen in three patients of the SB group and two of the DB group, with no difference determined between the groups (p > 0.05).

Conclusion

In the 5-year follow-up period, no difference was determined between patients undergoing SB ACL reconstruction and those undergoing DB ACL reconstruction regarding clinical scores, knee stability, and MRI findings, but graft maturation occurs later the patients undergoing DB reconstruction.

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Acknowledgements

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Funding

We have no financial biases.

Author information

Authors and Affiliations

  1. Department of Orthopedics and Traumatology, Faculty of Medicine, Ankara University, Ankara, Turkey

    Ramazan Akmeşe

  2. Department of Orthopedics and Traumatology, Etimesgut Şehit Sait Ertürk State Hospital, Ankara, Turkey

    Yener Yoğun

  3. Department of Orthopedics and Traumatology, Yunus Emre Training and Research Hospital, Eskişehir, Turkey

    İbrahim Küçükkarapinar

  4. Department of Orthopedics and Traumatology, Yozgat City Hospital, Yozgat, Turkey

    Mehmet Batu Ertan

  5. Department of Sports Medicine, Faculty of Medicine, Ankara University, Ankara, Turkey

    Mehmet Mesut Çelebi

  6. Department of Radiology, Faculty of Medicine, Ankara University, Ankara, Turkey

    Zehra Akkaya

Authors
  1. Ramazan Akmeşe
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  2. Yener Yoğun
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Contributions

RA: conceived and design the analysis, wrote the paper, performed operations. YY: wrote the paper, collected the data. İK performed the analysis, contributed data or analysis tools. MBE: wrote the paper. MMÇ: performed the analysis, collected the data. ZA: collected radiological data and evaluated.

Corresponding author

Correspondence to Yener Yoğun.

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Conflict of interest

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethical approval

We obtained ethical approval from review board of Ankara University Faculty of Medicine (No. 08-345-14).

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Informed consent was obtained from all individual participants included in the study.

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Patients signed informed consent regarding publishing their data.

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Akmeşe, R., Yoğun, Y., Küçükkarapinar, İ. et al. Radiological maturation and clinical results of double-bundle and single-bundle anterior cruciate ligament reconstruction. A 5-year prospective case-controlled trial. Arch Orthop Trauma Surg 142, 1125–1132 (2022). https://doi.org/10.1007/s00402-021-03971-4

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  • DOI: https://doi.org/10.1007/s00402-021-03971-4

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