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Double-Bundle Anterior Cruciate Ligament Reconstruction

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Rotatory Knee Instability

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Abstract

The concept of anatomic anterior cruciate ligament (ACL) reconstruction aims to restore the ACL to its native dimensions, collagen orientation, and insertion sites with the goal of providing the patient with the best potential for a successful outcome. Double-bundle (DB) ACL reconstruction is one application of the anatomic ACL reconstruction concept. According to biomechanical studies, this technique restores knee laxity closer to normal than transtibial single-bundle (SB) ACL reconstruction techniques. Several studies have shown that restoration of anteroposterior (AP) and rotational knee laxity, as measured by KT arthrometry and pivot-shift testing, respectively, is superior in DB reconstruction when compared to nonanatomic SB reconstruction. Evidence from high-quality meta-analyses also demonstrates that anatomic DB reconstruction allows for improved control of AP and rotational knee laxity when compared with nonanatomic SB reconstruction. Considering the heterogeneity of numerous studies, including the variability in femoral tunnel location, future biomechanical and long-term clinical cohort studies should be focused on further evaluation of laxity and functional outcomes of anatomic ACL reconstruction.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Kaufman Building Suite 1011, 3471 Fifth Avenue, Pittsburgh, PA, 15213, USA

    Sebastián Irarrázaval MD, Jonathan N. Watson MD, Marcio Albers MD, Daniel Guenther MD & Freddie H. Fu MD

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  1. Sebastián Irarrázaval MD
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  2. Jonathan N. Watson MD
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  3. Marcio Albers MD
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  4. Daniel Guenther MD
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  5. Freddie H. Fu MD
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Correspondence to Freddie H. Fu MD .

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Editors and Affiliations

  1. UPMC Center for Sports Medicine, Pittsburgh, Pennsylvania, USA

    Volker Musahl

  2. Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden

    Jón Karlsson

  3. Orthopaedic Surgery, Kobe University School of Medicine, Kobe, Japan

    Ryosuke Kuroda

  4. Istituto Ortopedico Rizzoli, University of Bologna, Bologna, Italy

    Stefano Zaffagnini

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Irarrázaval, S., Watson, J.N., Albers, M., Guenther, D., Fu, F.H. (2017). Double-Bundle Anterior Cruciate Ligament Reconstruction. In: Musahl, V., Karlsson, J., Kuroda, R., Zaffagnini, S. (eds) Rotatory Knee Instability. Springer, Cham. https://doi.org/10.1007/978-3-319-32070-0_31

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