Single-bundle patellar tendon versus non-anatomical double-bundle hamstrings ACL reconstruction: a prospective randomized study at 8-year minimum follow-up
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Stefano Zaffagnini • Danilo Bruni • Giulio Maria Marcheggiani Muccioli • Tommaso Bonanzinga • Nicola Lopomo • Simone Bignozzi • Maurilio Marcacci
- چاپ و سال / کشور: 2011
Description
Purpose The purpose of this study was to compare subjective, objective and radiographic outcome of the lateralized single-bundle bone-patellar tendon-bone autograft with a non-anatomical double-bundle hamstring tendons autograft anterior cruciate ligament (ACL) reconstruction technique at long-term follow-up. Methods Seventy-nine non-consecutive randomized patients (42 men; 37 women) with unilateral ACL insufficiency were prospectively evaluated, before and after ACL reconstruction by means of the above-mentioned techniques, with a minimum follow-up of 8 years (range 8–10 years; mean 8.6 years). In the double-bundle hamstrings technique, we used one tibial and one femoral tunnel combined with one ‘‘over-the-top’’ passage, cortical staple’s fixation and we left intact hamstrings’ tibial insertion. Patients were evaluated subjectively and objectively, using IKDC score, Tegner level, manual maximum displacement test with KT-2000TM arthrometer. Radiographic evaluation was performed according to IKDC grading system, and re-intervention rate for meniscal lesions was also recorded. Results The subjective and objective IKDC were similar in both groups while double-bundle hamstrings group showed significantly higher Tegner level (P = 0.0007), higher passive range of motion recovery (P = 0.0014), faster sport resumption (P = 0.0052), lower glide pivotshift phenomenon (P = 0.0302) and lower re-intervention rate (P = 0.0116) compared with patellar tendon group. Radiographic evaluation showed significant lower objective degenerative changes in double-bundle hamstrings group at final follow-up (P = 0.0056). Conclusion Although both techniques provide satisfactory results, double-bundle ACL reconstruction shows better functional results, with a faster return to sport activity, a lower re-operation rate and lower degenerative knee changes.
Knee Surg Sports Traumatol Arthrosc (2011) 19:390–397 DOI 10.1007/s00167-010-1225-y Received: 28 December 2009 / Accepted: 12 July 2010 / Published online: 29 July 2010
