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Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 10/2007

01.10.2007 | Knee

Double bundle or single bundle plus extraarticular tenodesis in ACL reconstruction?

A CAOS study

verfasst von: E. Monaco, L. Labianca, F. Conteduca, A. De Carli, A. Ferretti

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 10/2007

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Abstract

Anatomic reconstructions of anterior cruciate ligament (ACL) with double bundle gracilis and semitendonosus tendons graft, reproducing AM and PL bundles, have been introduced to offer a better biomechanical outcome, especially during rotatory loads. On the other hand, many methods of tenodesing the lateral aspect of the tibia to the femur to reduce internal rotation (IR) of the tibia and minimize anterior translation of the tibia relative to the femur as a backup for intra-articular reconstruction, have been also suggested. The goal of this study is to evaluate the effect, on the IR of the tibia, of a lateral reconstruction in addition to a standard single bundle ACL reconstruction as compared with an anatomic double bundle ACL reconstruction. Computer assisted ACL reconstruction has been used because it could be very effective in evaluating the global kinematic performance of the reconstructed knee. We selected 20 consecutive ACL reconstruction procedures to be performed in males in our hospital. Patients were alternately assigned to one of the two groups––group A: standard single bundle ACL reconstruction with doubled gracilis and semitendinosus tendons graft with an arthroscopically assisted two incisions technique and a lateral extraarticular reconstruction; group B: double bundle ACL reconstruction with doubled gracilis and semitendinosus tendons graft with an arthroscopically assisted two incisions technique. In all ACL reconstruction procedures navigation process was performed. Both surgical techniques reduced significantly AP displacement, IR and external rotation (ER) of the tibia respect to pre-operative ACL deficient condition (p < 0.05). Comparing the group A after the single bundle reconstruction and the group B after the AM bundle fixation, non differences were found in AP displacement, IR and ER of the tibia (p = 0.75, p = 0.07 and p = 0.07 respectively; power: 0.94). Comparing the group A after the addition of the lateral tenodesis and group B after the PL bundle fixation (AM + PL) no differences in AP tibial displacement and in ER of tibia were found (p = 0.9 and 0.15, respectively; power: 0.99); however a significant reduction in IR of the tibia was found in group A after the addition of the lateral tenodesis respect to the group B after the addition of the PL bundle (p = 0.0001; power: 0.26). On the basis of our study, the addition of a lateral extraarticular reconstruction to a standard single bundle ACL reconstruction with hamstrings tendons graft in an “in vivo” reconstruction, is more effective in reducing the IR of the tibia at 30° of knee flexion, as compared with a standard single bundle ACL reconstruction and with an anatomic double bundle reconstruction is confirmed.
Literatur
1.
Zurück zum Zitat Aglietti P, Buzzi R, Giron F, Simeone AJ, Zaccherotti G (1997) Arthroscopicassisted anterior cruciate ligament reconstruction with the central third patellar tendon: a 5–8-year follow-up. Knee Surg Sports Traumatol Arthrosc 5:138–144PubMedCrossRef Aglietti P, Buzzi R, Giron F, Simeone AJ, Zaccherotti G (1997) Arthroscopicassisted anterior cruciate ligament reconstruction with the central third patellar tendon: a 5–8-year follow-up. Knee Surg Sports Traumatol Arthrosc 5:138–144PubMedCrossRef
2.
Zurück zum Zitat Anderson AF, Snyder RB, Lipscomb AB Jr (2001) Anterior cruciate ligament reconstruction: a prospective randomized study of three surgical methods. Am J Sports Med 29:272–279PubMed Anderson AF, Snyder RB, Lipscomb AB Jr (2001) Anterior cruciate ligament reconstruction: a prospective randomized study of three surgical methods. Am J Sports Med 29:272–279PubMed
3.
Zurück zum Zitat Bach BR Jr, Tradonsky S, Bojchuk J, Levy ME, Bush-Joseph CA, Khan NH (1998) Arthroscopically assisted anterior cruciate ligament reconstruction using patellar tendon autograft: five- to nine-year follow-up evaluation. Am J Sports Med 26:20–29PubMed Bach BR Jr, Tradonsky S, Bojchuk J, Levy ME, Bush-Joseph CA, Khan NH (1998) Arthroscopically assisted anterior cruciate ligament reconstruction using patellar tendon autograft: five- to nine-year follow-up evaluation. Am J Sports Med 26:20–29PubMed
4.
Zurück zum Zitat Barrett GR, Noojin FK, Hartzog CW, Nash CR (2002) Reconstruction of the anterior cruciate ligament in females: a comparison of hamstring versus patellar tendon autograft. Arthroscopy 18:46–54PubMedCrossRef Barrett GR, Noojin FK, Hartzog CW, Nash CR (2002) Reconstruction of the anterior cruciate ligament in females: a comparison of hamstring versus patellar tendon autograft. Arthroscopy 18:46–54PubMedCrossRef
5.
Zurück zum Zitat Barrett GR, Richardson KJ (1995) The effect of added extra-articular procedure on results of ACL reconstruction. Am J Knee Surg 8:1–6PubMed Barrett GR, Richardson KJ (1995) The effect of added extra-articular procedure on results of ACL reconstruction. Am J Knee Surg 8:1–6PubMed
6.
Zurück zum Zitat Beynnon BD, Johnson RJ, Abate JA, et al (2005) Tratment of anterior cruciate ligament injuries, part I. Am J Sports Med 33:1579–1602PubMedCrossRef Beynnon BD, Johnson RJ, Abate JA, et al (2005) Tratment of anterior cruciate ligament injuries, part I. Am J Sports Med 33:1579–1602PubMedCrossRef
7.
Zurück zum Zitat Bull A, Amis A (1998) The pivot-shift phenomenon: a clinical and biomechanical perspective. Knee 5:141–158CrossRef Bull A, Amis A (1998) The pivot-shift phenomenon: a clinical and biomechanical perspective. Knee 5:141–158CrossRef
8.
Zurück zum Zitat Cha PS, Brucker PU, West RV, et al (2005) Arthroscopic double bundle anterior cruciate ligament reconstruction: an anatomic approach. Arthroscopy 21(10):1275e–1275e8CrossRef Cha PS, Brucker PU, West RV, et al (2005) Arthroscopic double bundle anterior cruciate ligament reconstruction: an anatomic approach. Arthroscopy 21(10):1275e–1275e8CrossRef
9.
Zurück zum Zitat Eichorn J (2004) Three years of experience with computer navigation assisted positioning of drilling tunnels in anterior cruciate ligament replacement (SS-67). Arthroscopy 20(supplement I):e31–e32CrossRef Eichorn J (2004) Three years of experience with computer navigation assisted positioning of drilling tunnels in anterior cruciate ligament replacement (SS-67). Arthroscopy 20(supplement I):e31–e32CrossRef
10.
Zurück zum Zitat Engebretsen L, Lew WD, Lewis JL, et al (1990) The effect of iliotibial tenodesis on intraarticular graft forces and knee joint motion. Am J Sports Med 18:169–176PubMedCrossRef Engebretsen L, Lew WD, Lewis JL, et al (1990) The effect of iliotibial tenodesis on intraarticular graft forces and knee joint motion. Am J Sports Med 18:169–176PubMedCrossRef
11.
Zurück zum Zitat Eriksson E (1997) How good are the results of ACL reconstruction? Knee Surg Sports Traumatol Arthrosc 5:137PubMedCrossRef Eriksson E (1997) How good are the results of ACL reconstruction? Knee Surg Sports Traumatol Arthrosc 5:137PubMedCrossRef
12.
Zurück zum Zitat Ferretti A., Conteduca F., Labianca L, et al (2005) Evolgate fixation of doubled flexor graft in ACL reconstruction: biomechanical evaluation with cyclic loading. Am J Sports Med 33(4):574–582PubMedCrossRef Ferretti A., Conteduca F., Labianca L, et al (2005) Evolgate fixation of doubled flexor graft in ACL reconstruction: biomechanical evaluation with cyclic loading. Am J Sports Med 33(4):574–582PubMedCrossRef
13.
Zurück zum Zitat Ferretti A, Conteduca F, Morelli F, et al (2003) The evolgate, a method to improve the pull-out strength of interference screw in tibial fixation of ACL reconstruction with DGST. Arthroscopy 19(9):936–40PubMedCrossRef Ferretti A, Conteduca F, Morelli F, et al (2003) The evolgate, a method to improve the pull-out strength of interference screw in tibial fixation of ACL reconstruction with DGST. Arthroscopy 19(9):936–40PubMedCrossRef
14.
Zurück zum Zitat Frank CB, Jackson DW (1997) The science of reconstruction of the anterior cruciate ligament. J Bone Joint Surg Am 79:1556–1576PubMed Frank CB, Jackson DW (1997) The science of reconstruction of the anterior cruciate ligament. J Bone Joint Surg Am 79:1556–1576PubMed
15.
Zurück zum Zitat Goertzen M, Schulitz KP (1993) [Comparison of combined extra- and intra-articular stabilization versus isolated arthroscopic semitendinosus repair after rupture of the anterior cruciate ligament]. Sportverletz Sportschaden 7:7–12 GermanPubMedCrossRef Goertzen M, Schulitz KP (1993) [Comparison of combined extra- and intra-articular stabilization versus isolated arthroscopic semitendinosus repair after rupture of the anterior cruciate ligament]. Sportverletz Sportschaden 7:7–12 GermanPubMedCrossRef
16.
Zurück zum Zitat Ishibashi Y, Tsuda E, Tazawa K (2005) Intraoperative evaluation of the anatomical double dindle anterior cruciate ligament reconstruction with OrthoPilot navigation system. Orthopaedics 28(10/supplement):s1277–s1282 Ishibashi Y, Tsuda E, Tazawa K (2005) Intraoperative evaluation of the anatomical double dindle anterior cruciate ligament reconstruction with OrthoPilot navigation system. Orthopaedics 28(10/supplement):s1277–s1282
17.
Zurück zum Zitat Kaplan N, Wickiewicz TL, Warren RF (1990) Primary surgical treatment of anterior cruciate ligament ruptures. A long-term followup study. Am J Sports Med 18:354–358PubMedCrossRef Kaplan N, Wickiewicz TL, Warren RF (1990) Primary surgical treatment of anterior cruciate ligament ruptures. A long-term followup study. Am J Sports Med 18:354–358PubMedCrossRef
18.
Zurück zum Zitat Kärrholm J, Selvik G, Elmqvist LG, et al (1988) Three-dimensional instability of the anterior cruciate deficient knee. J Bone Joint Surg Br 70:777–783PubMed Kärrholm J, Selvik G, Elmqvist LG, et al (1988) Three-dimensional instability of the anterior cruciate deficient knee. J Bone Joint Surg Br 70:777–783PubMed
19.
Zurück zum Zitat Kocher MS, Steadman JR, Briggs K, Zurakowski D, Sterett WI, Hawkins RJ (2002) Determinants of patient satisfaction with outcome after anterior cruciate ligament reconstruction. J Bone Joint Surg Am 84:1560–1572PubMed Kocher MS, Steadman JR, Briggs K, Zurakowski D, Sterett WI, Hawkins RJ (2002) Determinants of patient satisfaction with outcome after anterior cruciate ligament reconstruction. J Bone Joint Surg Am 84:1560–1572PubMed
20.
Zurück zum Zitat Koh J (2005) Computer assisted navigation and anterior cruciate ligament reconstruction: accuracy and outcomes. Orthopaedics 28(10/supplement):s1283–s1288 Koh J (2005) Computer assisted navigation and anterior cruciate ligament reconstruction: accuracy and outcomes. Orthopaedics 28(10/supplement):s1283–s1288
21.
Zurück zum Zitat Logan M, Dunstan E, Robinson J, et al (2004) Tibiofemoral kinematics of the anterior cruciate ligament (ACL)-deficient weightbearing, living knee employing vertical access open “Interventional” multiple resonance imaging. Am J Sports Med 32:720–726PubMedCrossRef Logan M, Dunstan E, Robinson J, et al (2004) Tibiofemoral kinematics of the anterior cruciate ligament (ACL)-deficient weightbearing, living knee employing vertical access open “Interventional” multiple resonance imaging. Am J Sports Med 32:720–726PubMedCrossRef
22.
Zurück zum Zitat MacIntosh DL, Darby JA (1976) Lateral substitution reconstruction. In: Proceedings of the Canadian Orthopaedic Association. J Bone Joint Surg Br 58:142 MacIntosh DL, Darby JA (1976) Lateral substitution reconstruction. In: Proceedings of the Canadian Orthopaedic Association. J Bone Joint Surg Br 58:142
23.
Zurück zum Zitat Pearl AJ, Bergfeld JA, editors (1992) Extraarticular reconstruction in the anterior cruciate ligament deficient knee. Champaign, Human Kinetics Pearl AJ, Bergfeld JA, editors (1992) Extraarticular reconstruction in the anterior cruciate ligament deficient knee. Champaign, Human Kinetics
24.
Zurück zum Zitat 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(4):542–552PubMedCrossRef 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(4):542–552PubMedCrossRef
25.
Zurück zum Zitat Ristanis S, Stergiou N, Patras K, Vasiliadis HS, Giakas G, Georgoulis AD (2005) Excessive tibial rotation during high-demand activities is not restored by anterior cruciate ligament reconstruction. Arthroscopy 21:1323–1329PubMedCrossRef Ristanis S, Stergiou N, Patras K, Vasiliadis HS, Giakas G, Georgoulis AD (2005) Excessive tibial rotation during high-demand activities is not restored by anterior cruciate ligament reconstruction. Arthroscopy 21:1323–1329PubMedCrossRef
26.
Zurück zum Zitat Shelbourne KD, Gray T (1997) Anterior cruciate ligament reconstruction with autogenous patellar tendon graft followed by accelerated rehabilitation: a two- to nine-year follow-up. Am J Sports Med 25:786–795PubMedCrossRef Shelbourne KD, Gray T (1997) Anterior cruciate ligament reconstruction with autogenous patellar tendon graft followed by accelerated rehabilitation: a two- to nine-year follow-up. Am J Sports Med 25:786–795PubMedCrossRef
27.
Zurück zum Zitat Stulberg SD, Yafe MA, Koo SK (2006) Computer assisted surgery versus manual total knee arthroplasty: a case-controlled study. J Bone Joint Surg Am 88:47–54PubMedCrossRef Stulberg SD, Yafe MA, Koo SK (2006) Computer assisted surgery versus manual total knee arthroplasty: a case-controlled study. J Bone Joint Surg Am 88:47–54PubMedCrossRef
28.
Zurück zum Zitat Tashman S, Collon D, Anderson K, Kolowich P, Anderst W (2004) Abnormal rotational knee motion during running after anterior cruciate ligament reconstruction. Am J Sports Med 32:975–983PubMedCrossRef Tashman S, Collon D, Anderson K, Kolowich P, Anderst W (2004) Abnormal rotational knee motion during running after anterior cruciate ligament reconstruction. Am J Sports Med 32:975–983PubMedCrossRef
29.
Zurück zum Zitat Terry GC, Hughston JC, Rose RM (1986) The anatomy of the iliopatellar band and iliotibial tract. Am J Sports Med 14:39–45PubMedCrossRef Terry GC, Hughston JC, Rose RM (1986) The anatomy of the iliopatellar band and iliotibial tract. Am J Sports Med 14:39–45PubMedCrossRef
30.
Zurück zum Zitat Valentin P, Hofbauer M, Aldrian S (2005) Clinical results of computer navigated anterior cruciate ligament reconstruction. Orthopaedics 28(10/supplement):s1289–s1291 Valentin P, Hofbauer M, Aldrian S (2005) Clinical results of computer navigated anterior cruciate ligament reconstruction. Orthopaedics 28(10/supplement):s1289–s1291
31.
Zurück zum Zitat Woo SLY, Kanamori A, Zeminski J, et al (2002) Anterior tibial and rotational loads with hamstrings and patellar tendon: a cadaveric study comparing the effectiveness of reconstruction of the anterior cruciate ligament. J Bone Joint Surg Am 84:907–914PubMed Woo SLY, Kanamori A, Zeminski J, et al (2002) Anterior tibial and rotational loads with hamstrings and patellar tendon: a cadaveric study comparing the effectiveness of reconstruction of the anterior cruciate ligament. J Bone Joint Surg Am 84:907–914PubMed
32.
Zurück zum Zitat Yagi M, Wong EH, Kanamori A, et al (2002) Biomechanical analysis of an anatomic anterior cruciate ligament reconstruction. Am J Sports Med 30(5):660–666PubMed Yagi M, Wong EH, Kanamori A, et al (2002) Biomechanical analysis of an anatomic anterior cruciate ligament reconstruction. Am J Sports Med 30(5):660–666PubMed
33.
Zurück zum Zitat Yasuda K, Kondo E, Ichiyama H, et al (2004) Anatomic reconstruction of the anteromedial and posterolateral bundles of the anterior cruciate ligament using hamstring tendon grafts. Arthroscopy 20:1015–1025PubMedCrossRef Yasuda K, Kondo E, Ichiyama H, et al (2004) Anatomic reconstruction of the anteromedial and posterolateral bundles of the anterior cruciate ligament using hamstring tendon grafts. Arthroscopy 20:1015–1025PubMedCrossRef
34.
Zurück zum Zitat Zaffagnini F, Marcacci M, Lo Presti M, et al (2006) Prospecitve and randomized evaluation of ACL reconstruction with three techniques: a clinical and radiographic evaluation at 5 years folow-up. Knee Surg Sports Traumatol Arthrosc 14:1060–1069PubMedCrossRef Zaffagnini F, Marcacci M, Lo Presti M, et al (2006) Prospecitve and randomized evaluation of ACL reconstruction with three techniques: a clinical and radiographic evaluation at 5 years folow-up. Knee Surg Sports Traumatol Arthrosc 14:1060–1069PubMedCrossRef
Metadaten
Titel
Double bundle or single bundle plus extraarticular tenodesis in ACL reconstruction?
A CAOS study
verfasst von
E. Monaco
L. Labianca
F. Conteduca
A. De Carli
A. Ferretti
Publikationsdatum
01.10.2007
Verlag
Springer-Verlag
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 10/2007
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-007-0368-y

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