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Comparable Results Between Lateralized Single- and Double-bundle ACL Reconstructions

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Clinical Orthopaedics and Related Research

Abstract

Patellar tendon autografts are not suitable for multibundle ACL reconstruction, a procedure that reportedly enhances postoperative knee stability. Biomechanical studies recommend lateral placement of the femoral tunnel for single-bundle reconstruction to improve postoperative knee kinematics. We asked whether a lateralized single-bundle patellar tendon graft (LSBP) would provide good short-term results of ACL reconstruction comparable to double-bundle hamstring tendon grafts (DBH). We prospectively followed 144 patients with unilateral ACL rupture treated with either LSBP or DBH in a nonrandomized fashion. Twenty-four female and 31 male patients with LSBP and 44 female and 26 male patients with DBH were followed for a minimum of 24 months (average, 38 months; range, 24–56 months). The patients with LSBP recovered knee extension better at 1 month compared with the patients with DBH, but extension was similar after 3 months. We observed no differences in the side-to-side difference of KT1000™ measurement, pivot shift test, or anterior drawer test between LSBP and DBH. Although better recovery of hamstring strength in LSBP and better recovery of quadriceps strength in DBH were observed in the early postoperative period, these differences disappeared after 12 months. There was no difference in International Knee Documentation Committee objective evaluation between LSBP and DBH at the final followup.

Level of Evidence: Level II, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Eiki Tsushima, PhD, Hirosaki University School of Health Science, for statistical analysis.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Zaifu-cho 5, Hirosaki, Aomori, 036-8562, Japan

    Eiichi Tsuda MD, Yasuyuki Ishibashi MD, Akira Fukuda MD, Harehiko Tsukada MD & Satoshi Toh MD

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  1. Eiichi Tsuda MD
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  2. Yasuyuki Ishibashi MD
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  3. Akira Fukuda MD
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  4. Harehiko Tsukada MD
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Correspondence to Eiichi Tsuda MD.

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Each author certifies that his institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent was obtained for participation in this study.

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Tsuda, E., Ishibashi, Y., Fukuda, A. et al. Comparable Results Between Lateralized Single- and Double-bundle ACL Reconstructions. Clin Orthop Relat Res 467, 1042–1055 (2009). https://doi.org/10.1007/s11999-008-0604-x

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  • DOI: https://doi.org/10.1007/s11999-008-0604-x

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