Skip to main content

Advertisement

SpringerLink
Log in

Sagittal and rotational knee stability following single- and double-bundle reconstruction of the anterior cruciate ligament: a randomized clinical trial

  • Original Article
  • Published:
European Orthopaedics and Traumatology

Abstract

Propose

The aim of this study was to compare the sagittal and rotational stability of anterior cruciate ligament (ACL) reconstructions with anatomic double-bundle and single-bundle techniques.

Methods

Twenty consecutive patients undergoing ACL reconstruction were randomized into two groups. One group was reconstructed with a single bundle in the anatomical position, while the other group was treated with an anatomical double-bundle technique. In both groups, the navigation equipment was used to measure the anterior tibial translation, internal tibial rotation, and external tibial rotation in 30° of flexion preoperatively and postoperatively.

Results

Both groups showed a significant reduction in anterior tibial translation, tibial internal rotation, and tibial external rotation from preoperative to postoperative (p < 0.001). There was no significant difference between single- and double-bundle groups in the preoperative values of tibial translation (22.30 mm ± 10.03 × 25.10 mm ± 8.02), internal (21.30 mm ± 6.98 × 21.10 mm ± 6.89), and external rotation (15.00 mm ± 4.16 × 17.90 mm ± 5.43). Postoperative mean in anterior tibial translation showed no statistical difference between groups (8.30 mm ± 5.66 × 12.80 mm ± 6.75). Internal rotation values (16.70 mm ± 5.08 × 17.30 mm ± 4.76) also showed no difference. Similarly, no statistical difference was found in external rotation (12.00 mm ± 4.57 × 13.90 mm ± 5.02).

Conclusion

ACL reconstructions using a single bundle in the anatomic position and ACL double-bundle reconstructions showed no significant difference in terms of anterior tibial translation, internal tibial rotation, or external tibial rotation when measured in 30° of flexion.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Frank CB, Jackson DW (1997) The science of reconstruction of the anterior cruciate ligament. J Bone Joint Surg Am Oct 79(10):1556–1576

    CAS  Google Scholar 

  2. Aglietti P, Buzzi R, Giron F, Simeone AJ, Zaccherotti G (1997) Arthroscopic-assisted anterior cruciate ligament reconstruction with the central third patellar tendon. A 5–8-year follow-up. Knee Surg Sports Traumatol Arthrosc 5(3):138–144

    Article  PubMed  CAS  Google Scholar 

  3. Bach BR Jr, Tradonsky S, Bojchuk J, Levy ME, Bush-Joseph CA, Khan NH (1998) Arthroscopically assisted anterior cruciate ligament reconstruction using patellar tendon autograft. Five- to nine-year follow-up evaluation. Am J Sports Med 26(1):20–29

    PubMed  Google Scholar 

  4. Howell SM, Gittins ME, Gottlieb JE, Traina SM, Zoellner TM (2001) The relationship between the angle of the tibial tunnel in the coronal plane and loss of flexion and anterior laxity after anterior cruciate ligament reconstruction. Am J Sports Med 29(5):567–574

    PubMed  CAS  Google Scholar 

  5. Woo SL, Kanamori A, Zeminski J, Yagi M, Papageorgiou C, Fu FH (2002) The effectiveness of reconstruction of the anterior cruciate ligament with hamstrings and patellar tendon. A cadaveric study comparing anterior tibial and rotational loads. J Bone Joint Surg Am 84-A(6):907–914

    PubMed  Google Scholar 

  6. Van Eck CF, Schreiber VM, Mejia HA, Samuelsson K, van Dijk CN, Karlsson J et al (2010) “Anatomic” anterior cruciate ligament reconstruction: a systematic review of surgical techniques and reporting of surgical data. Arthroscopy 26(9Suppl):S2–S12, review

    PubMed  Google Scholar 

  7. Heming JF, Rand J, Steiner ME (2007) Anatomical limitations of transtibial drilling in anterior cruciate ligament reconstruction. Am J Sports Med 35(10):1708–1715

    Article  PubMed  Google Scholar 

  8. Steiner ME, Battaglia TC, Heming JF, Rand JD, Festa A, Baria M (2009) Independent drilling outperforms conventional transtibial drilling in anterior cruciate ligament reconstruction. Am J Sports Med 37(10):1912–1919

    Article  PubMed  Google Scholar 

  9. Bartolozzi A, Gillespie M (1996) Revision anterior cruciate ligament reconstruction. Oper Tech Orthop 6:181–189

    Article  Google Scholar 

  10. Sati M, Stäubli H, Bourquin Y, Kunz M, Nolte LP (2002) Real-time computerized in situ guidance system for ACL graft placement. Comput Aided Surg 7(1):25–40

    PubMed  CAS  Google Scholar 

  11. Zaffagnini S, Klos TV, Bignozzi S (2010) Computer-assisted anterior cruciate ligament reconstruction: an evidence-based approach of the first 15 years. Arthroscopy 26(4):546–554

    Article  PubMed  Google Scholar 

  12. Muneta T, Sekiya I, Yagishita K, Ogiuchi T, Yamamoto H, Shinomiya K (1999) Two-bundle reconstruction of the anterior cruciate ligament using semitendinosus tendon with endobuttons: operative technique and preliminary results. Arthroscopy 15(6):618–624

    Article  PubMed  CAS  Google Scholar 

  13. Fu FH, Shen W, Starman JS, Okeke N, Irrgang JJ (2008) Primary anatomic double-bundle anterior cruciate ligament reconstruction: a preliminary 2-year prospective study. Am J Sports Med 36(7):1263–1274

    Article  PubMed  Google Scholar 

  14. Musahl V, Voos JE, O’Loughlin PF, Choi D, Stueber V, Kendoff D et al (2010) Comparing stability of different single- and double-bundle anterior cruciate ligament reconstruction techniques: a cadaveric study using navigation. Arthroscopy 26(9 Suppl):S41–S48

    PubMed  Google Scholar 

  15. Carneiro M, Navarro RD, Nakama GY, Barretto JM, Queiroz AB, Luzo MV (2009) Reconstrução do ligamento cruzado anterior com duplo feixe utilizando os tendões dos músculos semitendíneo e grácil: fixação com dois parafusos de interferência. Rev bras ortop 44(5):441–445

    Article  Google Scholar 

  16. Yasuda K, Kondo E, Ichiyama H, Tanabe Y, Tohyama H (2006) Clinical evaluation of anatomic double-bundle anterior cruciate. Arthroscopy 22(3):240–251

    Article  PubMed  Google Scholar 

  17. Ferretti M, Ekdahl M, Shen W, Fu FH (2007) Osseous landmarks of the femoral attachment of the anterior cruciate ligament: an anatomic study. Arthroscopy 23(11):1218–1225

    Article  PubMed  Google Scholar 

  18. van Eck CF, Lesniak BP, Schreiber VM, Fu FH (2010) Anatomic single- and double-bundle anterior cruciate ligament reconstruction flowchart. Arthroscopy 26(2):258–268

    Article  PubMed  Google Scholar 

  19. Rosner B (1986) Fundamentals of biostatistics, 2nd edn. PWS Publishers, Boston, p 584

    Google Scholar 

  20. Meredick RB, Vance KJ, Appleby D, Lubowitz JH (2008) Outcome of single-bundle versus double-bundle reconstruction of the anterior cruciate ligament: a meta-analysis. Am J Sports Med 36(7):1414–1421

    Article  PubMed  Google Scholar 

  21. Tsarouhas A, Iosifidis M, Kotzamitelos D, Spyropoulos G, Tsatalas T, Giakas G (2010) Three-dimensional kinematic and kinetic analysis of knee rotational stability after single- and double-bundle anterior cruciate ligament reconstruction. Arthroscopy 26(7):885–893

    Article  PubMed  Google Scholar 

  22. Ferretti A, Monaco E, Labianca L, Conteduca F, De Carli A (2008) Double-bundle anterior cruciate ligament reconstruction: a computer-assisted orthopaedic surgery study. Am J Sports Med 36(4):760–766

    Article  PubMed  Google Scholar 

  23. Yagi M, Wong EK, Kanamori A, Debski RE, Fu FH, Woo SL (2002) Biomechanical analysis of an anatomic anterior cruciate ligament reconstruction. Am J Sports Med 30(5):660–666

    PubMed  Google Scholar 

  24. Mae T, Shino K, Miyama T, Shinjo H, Ochi T, Yoshikawa H et al (2001) Single-versus two-femoral socket anterior cruciate ligament reconstruction technique: biomechanical analysis using a robotic simulator. Arthroscopy 17(7):708–716

    Article  PubMed  CAS  Google Scholar 

  25. Morimoto Y, Ferretti M, Ekdahl M, Smolinski P, Fu FH (2009) Tibiofemoral joint contact area and pressure after single- and double-bundle anterior cruciate ligament reconstruction. Arthroscopy 25(1):62–69

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors would like to thank Robert A. Magnussen from the Hôpital de la Croix-Rousse in Lyon, France, for the editorial assistance.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Knee Surgery Group, Department of Orthopaedics and Traumatology, Universidade Federal de São Paulo, Rua Borges Lagoa, 540, Vila Clementino, São Paulo, Brazil

    Pedro Debieux, Mario Carneiro, Antonio Altenor Bessa de Queiroz, Marcus Vinicius Malheiros Luzo, Geraldo Sergio Melo Granata Jr. & Fábio Pacheco Ferreira

Authors
  1. Pedro Debieux
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mario Carneiro
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Antonio Altenor Bessa de Queiroz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Marcus Vinicius Malheiros Luzo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Geraldo Sergio Melo Granata Jr.
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Fábio Pacheco Ferreira
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Pedro Debieux.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Debieux, P., Carneiro, M., de Queiroz, A.A.B. et al. Sagittal and rotational knee stability following single- and double-bundle reconstruction of the anterior cruciate ligament: a randomized clinical trial. Eur Orthop Traumatol 3, 49–54 (2012). https://doi.org/10.1007/s12570-012-0096-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12570-012-0096-8

Keywords

Search

Navigation