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Bi-socket ACL reconstruction using hamstring tendons: high versus low femoral socket placement

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

Abstract

To clarify the importance of the femoral socket location in bi-socket Anterior cruciate ligament (ACL) reconstruction. Subjects included 261 patients with an average age of 26 years who received ACL reconstruction via the high-femoral socket procedure (Group H) and 43 patients with an average age of 29 years who received ACL reconstruction via the low-femoral socket procedure (Group L) with a minimal follow-up of 24 months. In Group H, the femoral sockets were created at 1:00 or 11:00 and 2:00–2:30 or 9:30–10:00 of the intercondylar notch. In Group L, the two femoral sockets were drilled at 2:00 or 10:00 and 3:00 or 9:00. For the tibial side, a single tunnel was made at the center of the footprint. Evaluation was performed based on the IKDC Knee Examination Form. While 137 knees (52%) were graded as normal, 100 (38%) as nearly normal, 8 (3%) as abnormal, and 2 (1%) as severely abnormal with 14 (5%) re-injury in Group H, 38 knees (74%) were graded as normal, and 7 (16%) as nearly normal with 3 (7%) re-injury in Group L, showing a better subjective evaluation (P = 0.007). The average side-to-side differences in anterior laxity at manual maximum force with the KT-1000 were 1.1 ± 1.6 mm for Group H and 1.0 ± 1.6 mm for Group L without statistically significant differences excluding re-injured cases. There were 204 patients (83%) from Group H and 33 (83%) from Group L with values between −2 and 2 mm, while 228 (92%) patients from Group H and 38 (95%) from Group L had values distributed between −3 and 3 mm. While the bi-socket ACL reconstruction provided objectively satisfactory clinical outcomes in more than 90% of the patients, the low-femoral socket placement was found to subjectively achieve better outcomes.

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Authors and Affiliations

  1. Department of Orthopaedic Sports Medicine, Kansai Rosai Hospital, 3-1-69, Inabaso, Amagasaki, Hyogo, 660-0064, Japan

    Yukiyoshi Toritsuka

  2. Department of Orthopaedics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Hiroshi Amano & Yuzo Yamada

  3. Department of Orthopaedic Surgery, Hoshigaoka Koseinenkin Hospital, 4-8-1 Hoshigaoka, Hirakata, Osaka, 573-8511, Japan

    Masayuki Hamada

  4. Department of Orthopaedic Surgery, Yao City Hospital, 2-1-55 Minamitaishidou, Yao, Osaka, 581-0056, Japan

    Tomoki Mitsuoka

  5. Department of Orthopaedic Sports Medicine, Osaka Rosai Hospital, 1179-3 Nagasonecho, Sakai, Osaka, 591-8025, Japan

    Shuji Horibe

  6. Faculty of Comprehensive Rehabilitation, Osaka Prefecture University, 3-7-30, Habikino, Habikino, Osaka, 583-0872, Japan

    Konsei Shino

Authors
  1. Yukiyoshi Toritsuka
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  2. Hiroshi Amano
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  3. Yuzo Yamada
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  4. Masayuki Hamada
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  5. Tomoki Mitsuoka
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  6. Shuji Horibe
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  7. Konsei Shino
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Correspondence to Yukiyoshi Toritsuka.

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No author or related institution has received any financial benefit from research in this study.

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Toritsuka, Y., Amano, H., Yamada, Y. et al. Bi-socket ACL reconstruction using hamstring tendons: high versus low femoral socket placement. Knee Surg Sports Traumatol Arthr 15, 835–846 (2007). https://doi.org/10.1007/s00167-007-0304-1

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  • DOI: https://doi.org/10.1007/s00167-007-0304-1

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