Indications and contraindications for double-bundle ACL reconstruction
- 786 Downloads
Over recent years, double-bundle reconstruction has gained popularity after studies showed significant advantages of adding a second bundle with regard to outcomes and biomechanics; in particular, it resulted in less rotational instability than after reconstruction with a traditional single-bundle technique. As the focus shifted further towards the restoration of the native anatomy, both single-bundle and double-bundle ACL reconstruction were performed in an anatomical fashion and yielded similar results. To date, no consensus has developed as to whether double-bundle reconstruction is better than single-bundle reconstruction or vice versa. However, after surgeons started to individualise their surgical approach to the patient, it has been found that both the anatomical single- and double-bundle techniques have their own set of indications and contraindications. Reconstruction of the ligament should focus on restoration of the native functional and anatomical properties and should take the size, shape and orientation of the ACL into account. When indications and contraindications for the technique used are based on native anatomical characteristics, either a single-bundle or a double-bundle procedure can be performed according to the same double-bundle concept.
KeywordsAnterior Cruciate Ligament Anterior Cruciate Ligament Reconstruction Femoral Tunnel Tibial Tunnel Native Anterior Cruciate Ligament
- 4.Hussein M, van Eck CF, Cretnik A, Dinevski D, Fu FH (2012) Prospective randomized clinical evaluation of conventional single-bundle, anatomic single-bundle, and anatomic double-bundle anterior cruciate ligament reconstruction: 281 cases with 3- to 5-year follow-up. Am J Sports Med 40(3):512–520PubMedCrossRefGoogle Scholar
- 12.Girgis FG, Marshall JL, Monajem A (1975) The cruciate ligaments of the knee joint. Anatomical, functional and experimental analysis. Clin Orthop Relat Res (106):216–231Google Scholar
- 22.Araujo P, van Eck CF, Torabi M, Fu FH (2012) How to optimize the use of MRI in anatomic ACL reconstruction. Knee Surg Sports Traumatol Arthrosc. Aug 15 [Epub ahead of print]Google Scholar
- 36.Loh JC, Fukuda Y, Tsuda E, Steadman RJ, Fu FH, Woo SLY (2003) Knee stability and graft function following anterior cruciate ligament reconstruction: Comparison between 11 o’clock and 10 o’clock femoral tunnel placement. 2002 Richard O’Connor Award paper. Arthroscopy 19(3):297–304PubMedCrossRefGoogle Scholar