nach oben

Knee Surgery, Sports Traumatology, Arthroscopy

Erschienen in:

01.04.2012 | Knee

Comparison of anterior and rotatory laxity using navigation between single- and double-bundle ACL reconstruction: prospective randomized trial

verfasst von: Sahnghoon Lee, Hyoungmin Kim, Jak Jang, Sang Cheol Seong, Myung Chul Lee

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 4/2012

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To prospectively assess the anterior tibial translation and rotational kinematics of the knee joint as well as the clinical outcome after single-bundle (SB) and double-bundle (DB) anterior cruciate ligament (ACL) reconstruction.

Methods

Forty-two patients randomly underwent single-bundle (Group SB, n = 21) or double-bundle (Group DB, n = 21) ACL reconstruction using hamstring tendon autografts. Anterior tibial translation and rotatory laxity were measured prior to and after fixation of the graft during reconstruction under the guidance of a navigation system. Clinical outcome measurements included the evaluation of the joint stability and functional status.

Results

Anterior tibial translation and rotatory laxity were improved significantly at all degrees of knee flexion in both groups. The postoperative total rotation (sum of internal and external rotation) at 30° and 60° (26.6° vs. 24.0°; 28.7° vs. 25.1°) as well as postoperative change in external rotation at 60° (−1.4° vs. −4.6°), and a change in total rotation at 30° and 60° (−7.0° vs. −11.5°; −6.1° vs. −8.9°) differed between the two groups, with better stability in the DB group. At 2 years follow-up, IKDC subjective satisfaction score was significantly different between two groups (70.9 vs. 79.6), while manual and instrumented laxity, pivot shift tests, modified Lysholm score, Tegner activity score, thigh muscle strengths were not different. Correlation analysis showed little correlations between anterior laxity tests at follow-up, and the kinematic variables measured by navigation during surgery while pivot shift test, IKDC subjective satisfaction score, modified Lysholm score, and Tegner activity score were mainly correlated with navigation-measured rotations in both groups.

Conclusions

The kinematic tests in this study found evidence suggesting that the DB ACL reconstruction improved rotatory laxity better than the SB ACL reconstruction at 30° and 60° of flexion, but there was no difference in functional outcome at 2 years follow-up between SB and DB groups.

Level of evidence

Prospective comparative study, Level II.

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

Aglietti P, Buzzi R, D’Andria S, Zaccherotti G (1992) Arthroscopic anterior cruciate ligament reconstruction with patellar tendon. Arthroscopy 8:510–516PubMedCrossRef

Aglietti P, Giron F, Losco M, Cuomo P, Ciardullo A, Mondanelli N (2010) Comparison between single- and double-bundle anterior cruciate ligament reconstruction: a prospective, randomized, single-blinded clinical trial. Am J Sports Med 38:25–34PubMedCrossRef

Bach JM, Hull ML, Patterson HA (1997) Direct measurement of strain in the posterolateral bundle of the anterior cruciate ligament. J Biomech 30:281–283PubMedCrossRef

Bedi A, Musahl V, Lane C, Citak M, Warren RF, Pearle AD (2010) Lateral compartment translation predicts the grade of pivot shift: a cadaveric and clinical analysis. Knee Surg Sports Traumatol Arthrosc 18:1269–1276PubMedCrossRef

Bignozzi S, Zaffagnini S, Lopomo N, Fu FH, Irrgang JJ, Marcacci M (2010) Clinical relevance of static and dynamic tests after anatomical double-bundle ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 18:37–42PubMedCrossRef

Bull AM, Andersen HN, Basso O, Targett J, Amis AA (1999) Incidence and mechanism of the pivot shift. An in vitro study. Clin Orthop Relat Res 363:219–231PubMedCrossRef

Bull AM, Earnshaw PH, Katchburian MV, Hassan AN, Amis AA (2002) Intraoperative measurement of knee kinematics in reconstruction of the anterior cruciate ligament. J Bone Joint Surg Br 84:1075–1081PubMedCrossRef

Chouliaras V, Ristanis S, Moraiti C, Stergiou N, Georgoulis AD (2007) Effectiveness of reconstruction of the anterior cruciate ligament with quadrupled hamstrings and bone-patellar tendon-bone autografts: an in vivo study comparing tibial internal-external rotation. Am J Sports Med 35:189–196PubMedCrossRef

10.

Colombet P, Robinson J, Christel P, Franceschi J-P, Djian P (2007) Using navigation to measure rotation kinematics during ACL reconstruction. Clin Orthop Relat Res 454:59–65PubMedCrossRef

11.

Ferretti A, Monaco E, Labianca L, de Carli A, Maestri B, Conteduca F (2009) Double-bundle anterior cruciate ligament reconstruction: a comprehensive kinematic study using navigation. Am J Sports Med 37:1548–1553PubMedCrossRef

12.

Gobbi A, Mahajan V, Karnatzikos G, Nakamura N (2011) Single- versus double-bundle ACL reconstruction: is there any difference in stability and function at 3-year followup? Clin Orthop Relat Res. Epub doi:10.1007/s11999-011-1940-9

13.

Hamada M, Shino K, Horibe S, Mitsuoka T, Miyama T, Shiozaki Y, Mae T (2001) Single- versus bi-socket anterior cruciate ligament reconstruction using autogenous multiple-stranded hamstring tendons with endobutton femoral fixation: a prospective study. Arthroscopy 17:801–807PubMed

14.

Harner CD, Honkamp NJ, Ranawat AS (2008) Anteromedial portal technique for creating the anterior cruciate ligament femoral tunnel. Arthroscopy 24:113–115PubMedCrossRef

15.

Hart R, Krejzla J, Sváb P, Kocis J, Stipcák V (2008) Outcomes after conventional versus computer-navigated anterior cruciate ligament reconstruction. Arthroscopy 24:569–578PubMedCrossRef

16.

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:s1277–s1282PubMed

17.

Jarvela T (2007) Double-bundle versus single-bundle anterior cruciate ligament reconstruction: a prospective, randomize clinical study. Knee Surg Sports Traumatol Arthrosc 15:500–507PubMedCrossRef

18.

Kocher MS, Steadman JR, Briggs KK, Sterett WI, Hawkins RJ (2004) Relationships between objective assessment of ligament stability and subjective assessment of symptoms and function after anterior cruciate ligament reconstruction. Am J Sports Med 32:629–634PubMedCrossRef

19.

Koh J (2005) Computer-assisted navigation and anterior cruciate ligament reconstruction: accuracy and outcomes. Orthopedics 28:s1283–s1287PubMed

20.

Koh J, Koo SS, Leonard J, Kodali P (2006) Anterior cruciate ligament (ACL) tunnel placement: a radiographic comparison between navigated versus manual ACL reconstruction. Orthopedics 29:S122–S124PubMed

21.

Lewis PB, Parameswaran AD, Rue JP, Bach BRJ (2008) Systematic review of single-bundle anterior cruciate ligament reconstruction outcomes: a baseline assessment for consideration of double-bundle techniques. Am J Sports Med 36:2028–2036PubMedCrossRef

22.

Longo UG, King JB, Denaro V, Maffulli N (2008) Double-bundle arthroscopic reconstruction of the anterior cruciate ligament: does the evidence add up? J Bone Joint Surg Br 90:995–999PubMedCrossRef

23.

Lopomo N, Bignozzi S, Martelli S, Zaffagnini S, Iacono F, Visani A, Marcacci M (2009) Reliability of a navigation system for intra-operative evaluation of antero-posterior knee joint laxity. Comput Biol Med 39:280–285PubMedCrossRef

24.

Lopomo N, Zaffagnini S, Bignozzi S, Visani A, Marcacci M (2010) Pivot-shift test: analysis and quantification of knee laxity parameters using a navigation system. J Orthop Res 28:164–169PubMed

25.

Lubowitz JH (2009) Anteromedial portal technique for the anterior cruciate ligament femoral socket: pitfalls and solutions. Arthroscopy 25:95–101PubMedCrossRef

26.

Mae T, Shino K, Miyama T, Shinjo H, Yoshikawa H, Fujie H (2001) Single- versus two-femoral socket anterior cruciate ligament reconstruction technique: biomechanical analysis using a robotic simulator. Arthroscopy 17:708–716PubMedCrossRef

27.

Markolf KL, Park S, Jackson SR, McAllister DR (2009) Anterior-posterior and rotatory stability of single and double-bundle anterior cruciate ligament reconstructions. J Bone Joint Surg Am 91:107–118PubMedCrossRef

28.

Matsumoto H (1990) Mechanism of the pivot shift. J Bone Joint Surg Br 72:816–821PubMed

29.

Muneta T, Sekiya I, Yagishita K, Ogiuchi T, Yamamoto H, Shinomiya K (1999) Two-bundle reconstruction of the anterior cruciate ligament using semitendinosus tendon with endobuttons: operative technique and preliminary results. Arthroscopy 15:618–624PubMedCrossRef

30.

Noyes FR, Grood ES, Cummings JF, Wroble RR (1991) An analysis of the pivot shift phenomenon. The knee motions and subluxations induced by different examiners. Am J Sports Med 19:148–155PubMedCrossRef

31.

Plaweski S, Cazal J, Rosell P, Merloz P (2006) Anterior cruciate ligament reconstruction using navigation: a comparative study on 60 patients. Am J Sports Med 34:542–552PubMedCrossRef

32.

Radford WJ, Amis AA (1990) Biomechanics of a double prosthetic ligament in the anterior cruciate deficient knee. J Bone Joint Surg Br 72:1038–1043PubMed

33.

Ristanis S, Stergiou N, Patras K, Tsepis E, Moraiti C, Georgoulis AD (2006) Follow-up evaluation 2 years after ACL reconstruction with bone-patellar tendon-bone graft shows that excessive tibial rotation persists. Clin J Sport Med 16:111–116PubMedCrossRef

34.

Robinson J, Carrat L, Granchi C, Colombet P (2007) Influence of anterior cruciate ligament bundles on knee kinematics: clinical assessment using computer-assisted navigation. Am J Sports Med 35:2006–2013PubMedCrossRef

35.

Seon JK, Park SJ, Lee KB, Yoon TR, Kozanek M, Song EK (2009) Range of motion in total knee arthroplasty: a prospective comparison of high-flexion and standard cruciate-retaining designs. J Bone Joint Surg Am 91:672–679PubMedCrossRef

36.

Siebold R, Dehler C, Ellert T (2008) Prospective randomized comparison of double-bundle versus single-bundle anterior cruciate ligament reconstruction. Arthroscopy 24:137–145PubMedCrossRef

37.

Snyder-Mackler L, Fitzgerald GK, Bartolozzi AR, Ciccotti MG (1997) The relationship between passive joint laxity and functional outcome after anterior cruciate ligament injury. Am J Sports Med 25:191–195PubMedCrossRef

38.

Song EK, Oh LS, Gill TJ, Gadikota HR, Seon JK (2009) Prospective comparative study of anterior cruciate ligament reconstruction using the double-bundle and single-bundle techniques. Am J Sports Med 37:1705–1711PubMedCrossRef

39.

Tsuda E, Ishibashi Y, Fukuda A, Tsukada H, Toh S (2007) Validation of computer-assisted double-bundle anterior cruciate ligament reconstruction. Orthopedics 30:S136–S140PubMed

40.

Yagi M, Kuroda R, Nagamune K, Kurosaka M (2007) Double-bundle ACL reconstruction can improve rotational stability. Clin Orthop Relat Res 454:100–107PubMedCrossRef

41.

Yagi M, Wong EK, Kanamori A, Debski RE, Fu FH, Woo SL-Y (2002) Biomechanical analysis of an anatomic anterior cruciate ligament reconstruction. Am J Sports Med 30:660–666PubMed

42.

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 20:1015–1025PubMedCrossRef

43.

Zantop T, Herbort M, Raschke MJ, Fu FH, Petersen W (2007) The role of the anteromedial and posterolateral bundles of the anterior cruciate ligament in anterior tibial translation and internal rotation. Am J Sports Med 35:223–227PubMedCrossRef

Titel: Comparison of anterior and rotatory laxity using navigation between single- and double-bundle ACL reconstruction: prospective randomized trial
verfasst von: Sahnghoon Lee
Hyoungmin Kim
Jak Jang
Sang Cheol Seong
Myung Chul Lee
Publikationsdatum: 01.04.2012
Verlag: Springer-Verlag
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 4/2012
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-012-1880-2

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen.
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 4/2012

Assessment of rotatory laxity in anterior cruciate ligament-deficient knees using magnetic resonance imaging with Porto-knee testing device

The pivot shift: a global user guide

Can the pivot-shift be eliminated by anatomic double-bundle anterior cruciate ligament reconstruction?

What does it take to have a high-grade pivot shift?

The role of static and dynamic rotatory laxity testing in evaluating ACL injury