J Knee Surg 2012; 25(03): 237-244
DOI: 10.1055/s-0031-1299661
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

ACL Reconstruction with Single Tibial Tunnel: Single Versus Double Bundle

Antonio Maestro
1   Department of Orthopaedic Surgery, FREMAP, Gijon, Spain
,
Alberto Sicilia
2   Department of Oral Surgery, University of Oviedo, Oviedo, Spain
,
Luis Rodriguez
3   Department of Orthopaedic Surgery, Hospital of Cabuenes, Gijon, Spain
,
Pedro Garcia
4   Department of Radiology, Hospital of Cabuenes, Gijon, Asturias, Spain
,
Jesus Fdez-Lombardia
5   Department of Orthopaedic Surgery, Hospital de Oriente, Arriondas, Asturias, Spain
,
Enrique Guerado
6   Department of Orthopaedic Surgery, Hospital of Costa Sol, Marbella, Spain
› Author Affiliations
Further Information

Publication History

30 April 2011

21 August 2011

Publication Date:
03 May 2012 (online)

Abstract

Double-bundle (DB) anterior cruciate ligament (ACL) reconstruction is designed with the aim of reproducing the anatomy and the function of a healthy knee. This can be done by creating two femoral tunnels and one tibial tunnel (DB-3T), or two femoral and two tibial tunnels (DB-4T), There is very little comparative information regarding DB-3T, which is supposed to be more anatomical than DB-4T, and single bundle (SB). DB-3T reconstruction produces greater joint stability and clinical behavior than SB. Consecutive patients with a unilateral rupture of the ACL treated with the DB-3T technique, and a control group of 36 nonconcurrent patients, with similar conditions, treated with the SB technique were followed during 2 years. Anterior/posterior translation (APT), pivot-shift test, one-leg hop, and IKDC (International Knee Documentation Committee) subjective evaluations were performed. There were no significant differences in the reduction of APT. However, there was a significant improvement in the remaining parameters in the DB-3T group: greater reduction in rotational instability, greater one-leg hop capacity, and greater subjective evaluation. At the 2-year follow-up, patients having undergone ACL reconstruction using hamstring tendons by means of a DB technique with a single tibial tunnel showed greater rotational stability, greater one-legged hop capacity, and a greater subjective evaluation than those having undergone SB reconstruction.

 
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