Double-bundle versus triple-bundle anatomical anterior cruciate ligament reconstruction using a hamstring autograft : a prospective randomized controlled trial
ESSKA Academy. Kamiya T. May 12, 2018; 218113; FP43-723
Tomoaki Kamiya
Tomoaki Kamiya
Login now to access Regular content available to all registered users.

You can access free non-premium educational content on the ESSKA Academy Portal by registering for free as 'ESSKA Academy User' here
Discussion Forum (0)
Rate & Comment (0)
Objectives: The anatomical anterior cruciate ligament (ACL) reconstruction could restore knee stability without loss of motion. The good clinical results of arthroscopic anatomical double-bundle (DB) and triple-bundle (TB) reconstruction using hamstring autograft were reported. However, there were no reports compared with two surgical procedures. The purpose of this study was to compare clinical outcomes between anatomical DB ACL reconstruction and TB ACL reconstruction.

Methods: From April 2013 to August 2015, 45 consecutive patients who underwent anatomical ACL reconstruction using hamstring autograft were examined. The patients were randomly divided into two groups (DB group or TB group). Femoral tunnels for anteromedial and posterolateral graft were created to all of patients. On the other hand, two (DB group) or three (TB group) tibial tunnels were made respectively. Every tunnel was created in anatomical ACL footprint using outside-in technique. The grafts were passed bone tunnels and fixed at 20 degrees of knee flexion with 20 Newtons of tensioning each graft using ligament tensioners. Range of motion, Lachman test, pivot shift test, knee laxity, and Tegner activity level scale were evaluated after two years from operation. Patient-reported outcome measure for ACL (JACL-25) were also obtained. Statistical analysis was performed with SPSS. Student t-test was used to compare both group. A p-value < 0.05 was considered statistical significance.

Results: 24 subjects (DB group) and 21 subjects (TB group) were included. There were no significant differences concerning about background of both group. Re-injury of ACL graft occurred five patients (DB group; 3, TB group; 2) within two years. Other patients were evaluated the physical examination and clinical outcomes after two years from operation. Loss of knee extension and flexion were not observed in all of patients. Lachman test was also negative in all of them. Three patients (DB group) and one patient (TB group) were presented glide pivot shift test. The others were negative. The average side-to-side difference in anterior laxity at manual maximum force with knee arthrometer were 1.1±1.0mm (DB group) and 0.9±1.1mm (TB group) respectively. There were no significant differences concerning about mean total score of JACL-25 (DB group; 26.0±27.0, TB group; 26.4±20.7). One questionnaire was significantly improved in TB group compared with DB group.

Conclusions: In this prospective randomized study, the primary variable, the pivot-shift test, and other subjective and objective outcome variables revealed no significant differences between the DB and TB techniques at 2 years after ACL reconstruction. Further studies involving larger sample sizes and longer-term follow-up are required.

anterior cruciate ligament, anatomical reconstruction, prospective randomized controlled trial
Code of conduct/disclaimer available in General Terms & Conditions
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.

Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.

Google Analytics is used for user behavior tracking/reporting. Google Analytics works in parallel and independently from MLG’s features. Google Analytics relies on cookies and these cookies can be used by Google to track users across different platforms/services.

Save Settings