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Intraoperative evaluation of anteroposterior and rotational stabilities in anterior cruciate ligament reconstruction: lower femoral tunnel placed single-bundle versus double-bundle reconstruction

  • Knee
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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Twenty-six patients with anteroposterior (AP) laxity of the knee, associated with torn anterior cruciate ligament (ACL), were prospectively randomized for arthroscopic lower femoral tunnel placed single- or double-bundle reconstruction using hamstring tendons. We evaluated AP and rotational stabilities under regular loads (a 100-N anterior load and a 1.5-N m external–internal load) before and after ACL reconstruction, comparing single- and double-bundle reconstruction with our original device for applying quantitative tibial rotation and the navigation system intraoperatively. No significant differences were found between the two groups in AP displacement and total range of tibial rotation at 30° and 60° of knee flexion. We found that a lower femoral tunnel placed single-bundle reconstruction reproduced AP and rotational stability as well as double-bundle reconstruction after reconstruction intraoperatively.

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References

  1. Adachi N, Ochi M, Uchio U, Iwasa J, Kuriwaka M, Ito Y (2004) Reconstruction of the anterior cruciate ligament:single-versus double-bundle multistranded hamstring tendons. J Bone Joint Surg 86B:515–520

    Google Scholar 

  2. Aglietti P, Giron F, Cuomo P, Losco M, Mondanelli N (2007) Single-and double-incision double-bundle ACL reconstruction. Clin Orthop 454:108–113

    Article  PubMed  Google Scholar 

  3. Amis AA, Dawkins PC (1991) Functional anatomy of the anterior cruciate ligament: fibre bundle actions related to ligament replacements and injuries. J Bone Joint Surg 73B:260–267

    Google Scholar 

  4. Bach BR Jr, Warren RF, Wickiewicz TL (1988) The pivot shift phenomenon: results and description of a modified clinical test for anterior cruciate ligament insufficiency. Am J Sports Med 16:571–576

    Article  PubMed  Google Scholar 

  5. Buoncristiani AM, Tjoumakaris FP, Starman JS, Ferretti M, Fu FH (2006) Anatomic double-bundle anterior cruciate ligament reconstruction. Arthroscopy 22:1000–1006

    PubMed  Google Scholar 

  6. Christel P, Franceschi JP et al (2005) Anatomic anterior cruciate ligament reconstruction: the French experience. Oper Tech Orthop 15:103–110

    Article  Google Scholar 

  7. Fu FH, Zelle BA, Beasley LS (2005) The double-bundle technique: the restration of normal kinematics. In: Proceedings of arthroscopy association of North America 2005 specialty day, Washington, 26 February 2005, pp 284–289

  8. Hole RL, Lintner DM, Kamaric E, Moseley JB (1996) Increased tibial translation after partial sectioning of the anterior cruciate ligament: the posterolateral bundle. Am J Sports Med 24:556–560

    Article  PubMed  CAS  Google Scholar 

  9. Hughston JC, Andrews JR, Cross MJ, Moschi A (1976) Classification of knee ligament instabilities: part I: the medial compartment and cruciate ligaments. J Bone Joint Surg 58A:159–172

    Google Scholar 

  10. Ishibashi Y, Tsuda E, Tazawa K, Sato H, Toh S (2005) Intraoperative evaluation of the anatomical double-bundle anterior cruciate ligament reconstruction with the orthopilot navigation system. Orthopedics 28:1277–1282

    Google Scholar 

  11. Järvelä T, Moisala AS, Sihvonen R, Järvelä S, Kannus P, Järvinen M (2008) Double-bundle anterior cruciate ligament reconstruction using hamstring autografts and bioabsorbable interference screw fixation: prospective, randomized, clinical study with 2-year results. Am J Sports Med 36:290–297

    Article  PubMed  Google Scholar 

  12. Kanamori A, Zeminski J, Rudy TW, Li G, Fu FH, Woo SL (2002) The effect of axial tibial torque on the function of the anterior cruciate ligament: a biomechanical study of a simulated pivot shift test. Arthroscopy 18:394–398

    PubMed  Google Scholar 

  13. Kurosawa H, Yamakoshi K, Yasuda K, Sasaki T (1991) Simultaneous measurement of changes in length of the cruciate ligaments during knee motion. Clin Orthop 265:233–240

    PubMed  Google Scholar 

  14. Loh JC, Fukuda Y, Tsuda E, Steadman RJ, Fu FH, Woo SL (2003) Knee stability and graft function following anterior cruciate ligament reconstruction: comparison between 11 o’clock and 10 o’clock femoral tunnel placement. Arthroscopy 19:297–304

    PubMed  Google Scholar 

  15. Miyasaka KC, Daniel DM, Stone ML et al (1991) The incidence of knee ligament injuries in the general population. Am J Knee Surg 4:3–8

    Google Scholar 

  16. Musahl V, Plakseychunk A, VanScyoc A et al (2005) Varying femoral tunnels between the anatomical footprint and isometric position: Effect on kinematics of the anterior cruciate ligament reconstructed knee. Am J Sports Med 33:712–718

    Article  PubMed  Google Scholar 

  17. Philippe C, James R et al (2007) Using navigation to measure rotation kinematics during ACL reconstruction. Clin Orthop 454:59–65

    Article  Google Scholar 

  18. Sbihi A, Franceschi JP et al (2004) Anterior cruciate ligament reconstruction: biomechanical comparison on cadaver specimens using a single or double hamstring technique. Rev Chir Orthop Reparatrice Appar Mot 90:643–650

    PubMed  CAS  Google Scholar 

  19. Scopp JM, Jasper LE, Belkoff SM, Moorman CT 3rd (2004) The effect of oblique femoral tunnel placement on rotational constraint of the knee reconstructed using patellar tendon autografts. Arthroscopy 20:294–299

    PubMed  Google Scholar 

  20. Slocum DB, James SL, Larson RL, Singer KM (1976) Clinical test for anterolateral rotatory instability of the knee. Clin Orthop 118:63–69

    PubMed  Google Scholar 

  21. 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 30:660–666

    PubMed  Google Scholar 

  22. Yagi M, Kuroda R, Nagamune K, Yoshiya S, Kurosaka M (2006) Double-bundle ACL reconstruction can improve rotational stability. Clin Orthop 454:100–107

    Google Scholar 

  23. Yamamoto Y, Hsu WH, Woo SL, Van Scyoc AH, Takakura Y, Debski RE (2004) Knee stability and graft function after anterior cruciate ligament reconstruction: a comparison of a lateral and an anatomical femoral tunnel placement. Am J Sports Med 32:1825–1832

    Article  PubMed  Google Scholar 

  24. Yasuda K, Kondo E, Ichiyama H, Kitamura N, Tanabe Y, Tohyama H, Minami A (2004) Anatomic reconstruction of the anteromedial and posterolateral bundles of the anterior cruciate ligament using hamstring tendon grafts. Arthroscopy 20:1015–1025

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan

    Atsushi Kanaya, Mitsuo Ochi, Masataka Deie, Nobuo Adachi, Makoto Nishimori & Atsuo Nakamae

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  1. Atsushi Kanaya
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  2. Mitsuo Ochi
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  3. Masataka Deie
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  4. Nobuo Adachi
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  5. Makoto Nishimori
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  6. Atsuo Nakamae
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Correspondence to Atsushi Kanaya.

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Kanaya, A., Ochi, M., Deie, M. et al. Intraoperative evaluation of anteroposterior and rotational stabilities in anterior cruciate ligament reconstruction: lower femoral tunnel placed single-bundle versus double-bundle reconstruction. Knee Surg Sports Traumatol Arthrosc 17, 907–913 (2009). https://doi.org/10.1007/s00167-009-0757-5

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  • DOI: https://doi.org/10.1007/s00167-009-0757-5

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