Severyns M, Mallet J, Plawecki S. Comparison of Rotatory and Sagittal Laxity After Single-Bundle Versus Double-Bundle ACL Reconstruction: Outcomes at 7-Year Follow-up.
Orthop J Sports Med 2022;
10:23259671221104408. [PMID:
36035893 PMCID:
PMC9403471 DOI:
10.1177/23259671221104408]
[Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 03/31/2022] [Indexed: 11/25/2022] Open
Abstract
Background:
Biomechanical studies have shown excellent anteroposterior and rotatory
laxity control after double-bundle (DB) anterior cruciate ligament (ACL)
reconstruction, but no clinical studies have compared midterm (>5-year)
residual laxity between the DB and single-bundle (SB) techniques.
Purpose:
To clinically compare sagittal and rotatory laxities and residual sagittal
laxity on the KT-1000 arthrometer between patients treated with an SB ACL
reconstruction and those treated with a DB ACL reconstruction at the 7-year
follow-up.
Study Design:
Cohort study; Level of evidence, 3.
Methods:
A total of 110 patients were included between January 2006 and December 2007.
The patients were randomly assigned into 2 groups: those treated with SB ACL
reconstruction (n = 63) and those treated with the DB technique (n = 47).
All patients were then reviewed at a minimum of 7 years of follow-up;
patients with ACL rerupture (n = 3 in the SB group and n = 2 in the DB
group) were excluded from the postoperative comparative analysis. Residual
anterior laxity (Lachman test), rotatory laxity (pivot-shift test), and
sagittal laxity (KT-1000 arthrometer side-to-side difference) were measured
and compared between the 2 groups.
Results:
The mean age at surgery was 23.0 ± 5.1 years for the DB group and 28.1 ± 7.0
years for the SB group, and the mean follow-up was 7.4 ± 0.8 years. No
statistically significant differences were found between the 2 groups in
terms of age, sex, preoperative laxity on KT-1000, preoperative Tegner
score, or concomitant meniscal lesions. Residual postoperative laxity via
Lachman testing (P < .01), pivot-shift testing
(P = .042), and the KT-1000 arthrometer
(P < .01) was statistically significantly in favor
of DB reconstruction.
Conclusion:
DB ACL reconstruction allowed better control of anterior stability during the
evaluation via the Lachman test and via objective measurement on the
KT-1000, as well as rotatory stability at a minimum of 7 years of
follow-up.
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