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In vivo knee rotational stability 2 years after double-bundle and anatomic single-bundle ACL reconstruction

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

The objective of this study was to evaluate knee rotational stability at least 2 years after anatomic single-bundle anterior cruciate ligament (ACL) reconstruction (SB) and double-bundle ACL reconstruction (DB) in comparison with the contralateral healthy knee joint. The Cincinnati, Lysholm and IKDC scores were analysed too.

Methods

There were 40 patients in both groups, the mean follow-up was 27 months. For all measurements, the navigation system OrthoPilot was used. Measurement started with the patient in the standing position in neutral rotation. Then, the patient achieved in 30° knee flexion under weight-bearing maximal external trunk rotation and returned to the neutral position. The same measurement was done for the internal trunk rotation. For the anterior–posterior stability, KT-1000 arthrometer was used. All measurements were repeated three times for each knee joint.

Results

After the DB reconstruction, the mean external rotation of the tibia (ER) was 8.2° and the internal rotation (IR) was 10.2°. In the contralateral healthy knee joint, ER was 8.5° (p = 0.597) and IR was 12.1° (p = 0.064). After the SB reconstruction, ER was 9.4° and IR was 13.1°. In the contralateral healthy knee joint, ER was 7.7° (p = 0.066) and IR was 9.8° (p = 0.005). Anterior–posterior translation was to the same extent for both groups.

Conclusions

The DB reconstruction of the ACL restores the rotational stability of the knee joint without any significant difference in comparison to the contralateral healthy knee (p > 0.05). The main finding of this study is that the internal rotational stability of the knee joint after the anatomic SB technique is not sufficient.

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References

  1. Mommersteegi TJA. The fibre bundle anatomy of human cruciate ligaments. J Anat. 1995;187:461–71.

    Google Scholar 

  2. Girgis FG. The cruciate ligaments of the knee joint-anatomical, functional and experimental analysis. Clin Orthop. 1975;106:216–31.

    Article  Google Scholar 

  3. Kaya A. Evaluation of the two bundles of the anterior cruciate ligament with 1.5 T magnetic resonance imaging. Acta Orthop Traumatol Turc. 2010;44(1):54–62.

    Article  PubMed  Google Scholar 

  4. Lorenz S. Radiologic evaluation of the insertion sites of the 2 functional bundles of the anterior cruciate ligament using 3-dimensional computed tomography. Am J Sports Med. 2009;37(12):2368–76.

    Article  PubMed  Google Scholar 

  5. Colombet P. Morphology of anterior cruciate ligament attachments for anatomic reconstruction: a cadaveric dissection and radiographic study. Arthroscopy. 2006;22(9):984–92.

    Article  PubMed  Google Scholar 

  6. Hart R. Hamstring versus quadriceps tendon graft in double-bundle anterior cruciate ligament reconstruction. Acta Chir Ort Traum Čechoslovaca. 2010; 77:296–303.

    CAS  Google Scholar 

  7. Petersen W. Anatomy of the anterior cruciate ligament with regard to its two bundles. Clin Orthop Relat Res. 2010;454:35–47.

    Article  Google Scholar 

  8. Steckel H. Arthroscopic evaluation of the ACL double bundle structure. Knee Surg Sports Traumatol Arthrosc. 2009;17(7):782–85.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Forsythe B. The location of femoral and tibial tunnels in anatomic double-bundle anterior cruciate ligament reconstruction analyzed by three-dimensional computed tomography models. J Bone Jt Surg Am. 2010;92:1418–26.

    Article  Google Scholar 

  10. Martins CAQ. The concept of anatomic anterior cruciate ligament reconstruction. Oper Tech Sports Med. 2008;16:104–15.

    Article  Google Scholar 

  11. Kopf S. A systematic review of the femoral origin and tibial insertion morphology of the ACL. Knee Surg Sports Traumatol Arthrosc. 2009;17:213–19.

    Article  PubMed  Google Scholar 

  12. Zantop T. Tunnel positioning of anteromedial and posterolateral bundles in anatomic anterior cruciate ligament reconstruction anatomic and radiographic findings. Am J Sports Med. 2008;36(1):65–72.

    Article  PubMed  Google Scholar 

  13. Ferretti M. Osseous landmarks of the femoral attachment of the anterior cruciate ligament: an anatomic study. Arthroscopy. 2007;23(11):1218–25.

    Article  PubMed  Google Scholar 

  14. Purnell ML. Anterior cruciate ligament insertions on the tibia and femur and their relationships to critical bony landmarks using high-resolution volume-rendering computed tomography. Am J Sports Med. 2008;36(11):2083–90.

    Article  PubMed  Google Scholar 

  15. Ho JY. Equal Kinematics Between Central Anatomic Single-Bundle and Double-Bundle Anterior Cruciate Ligament Reconstructions. Arthroscopy. 2009; 25(5):464–72.

    Article  PubMed  Google Scholar 

  16. Bedi A. A comparison of the effect of central anatomical single-bundle anterior cruciate ligament reconstruction and double-bundle anterior cruciate ligament reconstruction on pivot-shift kinematics. Am J Sports Med. 2010;38(9):1788–94.

    Article  PubMed  Google Scholar 

  17. Hofbauer M. Rotational and translational laxity after computer-navigated single- and double-bundle anterior cruciate ligament reconstruction. Knee Surf Sports Traumatol Arthrosc. 2010;18:1201–7.

    Article  CAS  Google Scholar 

  18. Song EK. Prospective comparative study of anterior ligament reconstruction using the double-bundle and single bundle technique. Am J Sports Med. 2009;37(1705):1705–11.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Komzák M. AM bundle controls the anterior–posterior and rotational stability to a greater extent than the PL bundle—a cadaver study. Knee. 2013;20(6):551–5.

    Article  PubMed  Google Scholar 

  20. Komzák M. Does the posterolateral bundle influence rotational movement more than the anteromedial bundle in anterior cruciate ligament reconstruction?: a clinical study. J Bone Jt Surf Br. 2012;94(10):1372–6.

    Article  Google Scholar 

  21. Gobbi A. Single versus double-bundle ACL reconstruction: is there any difference in stability and function at 3-year followup? Clin Orthop Relat Res. 2012;470(3):824–34.

    Article  PubMed  Google Scholar 

  22. Suomalainen P. Double-bundle versus single-bundle anterior cruciate ligament reconstruction: a prospective randomised study with 5-year results. Am J Sports Med. 2012;40(7):1511–18.

    Article  PubMed  Google Scholar 

  23. Hoshino Y. Can joint contact dynamics be restored by anterior cruciate ligament reconstruction? Clin Orthop Relat Res. 2013;427:2924–31.

    Article  Google Scholar 

  24. Chouteau J. Knee rotational laxity and proprioceptive function 2 years after partial ACL reconstruction. Knee Surg Sports Traumatol Arthrosc. 2012;20(4):762–6.

    Article  CAS  PubMed  Google Scholar 

  25. Kondo E. Biomechanical comparison of anatomic double-bundle, anatomic single-bundle, and nonanatomic single-bundle anterior cruciate ligament reconstructions. Am J Sports Med. 2011;39(2):279–88.

    Article  PubMed  Google Scholar 

  26. Filbay SR. Health-related quality of life after anterior cruciate ligament reconstruction. A systematic review. Am J Sports Med. 2014;42(5):1247–55.

    Article  PubMed  Google Scholar 

  27. Mae T. Immediate postoperative anterior knee stability: double- versus triple-bundle anterior cruciate ligament reconstructions. Arthroscopy. 2013;29(2):213–19.

    Article  PubMed  Google Scholar 

Download references

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Correspondence to M. Komzák.

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Conflict of interest

Martin Komzák, Radek Hart, Martin Feranec, Petr Šmíd, and Radka Kocová declare that they have no conflict of interest.

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Komzák, M., Hart, R., Feranec, M. et al. In vivo knee rotational stability 2 years after double-bundle and anatomic single-bundle ACL reconstruction. Eur J Trauma Emerg Surg 44, 105–111 (2018). https://doi.org/10.1007/s00068-017-0769-7

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  • DOI: https://doi.org/10.1007/s00068-017-0769-7

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