Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original ArticleA Prospective Randomized Study of 4-Strand Semitendinosus Tendon Anterior Cruciate Ligament Reconstruction Comparing Single-Bundle and Double-Bundle Techniques
Section snippets
Methods
This randomized prospective study was performed in patients between July 2002 and March 2004. ACL was performed in 84 patients (85 knees). Single-bundle reconstruction was selected in patients whose birthdays were on odd-numbered days, and double-bundle reconstruction was selected in those whose birthdays were on even-numbered days. Four-strand ST tendon was used for the graft in every patient without any exception in this series. The same preoperative and postoperative program was used for
Knee extension/flexion angles and thigh girth
The differences in the maximum extension angle of the knee averaged 0.8° in the single-bundle group and 0.6° in the double-bundle group. The differences were not statistically significant. The differences in the maximum flexion angle of the knee averaged 1.0° in the single-bundle group and 0.9° in the double-bundle group. These differences were not statistically significant either. There was no patient with a greater than 5° extension or flexion deficit in either group.
The thigh girth
Discussion
To achieve better stability of the ACL reconstruction via STG, Muneta et al.21 developed a reconstruction technique creating 2 tunnels for both the tibia and femur (double-bundle technique) with EndoButtons for femoral graft fixation. Double-bundle ACL reconstruction with 2 tibial and 2 femoral tunnels is not new22; however, the new double-bundle ACL reconstruction has introduced a new technical field using an arthroscopically assisted technique with a roof impingement concept23 for the tibial
Conclusions
This is the first comparative study in a randomized prospective fashion to evaluate the significance of the double-bundle ACL reconstruction technique compared with the single-bundle technique. The results indicated that double-bundle ACL reconstruction via 4-strand ST is superior to the single-bundle technique with regard to anterior and rotational stability; however, it failed to show any subjective difference.
Acknowledgment
The authors thank Professor Kenichi Shinomiya for his support.
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The authors report no conflict of interest.