J Korean Orthop Assoc.  2011 Aug;46(4):312-319. 10.4055/jkoa.2011.46.4.312.

Comparison of Tunnel Enlargement between Single and Double Bundle Anterior Cruciate Ligament Reconstruction

• Lee JH
• Wang SI
• Park JH
• Bae HK

• KMID: 2185429
• DOI: http://doi.org/10.4055/jkoa.2011.46.4.312

Abstract

PURPOSE
The aim of this study was to compare the tunnel enlargement in patients who had undergone a double-bundle (DB) or single-bundle (SB) anterior cruciate ligament (ACL) reconstruction, and to determine the correlation between the extent of bone tunnel enlargement and the clinical results.
MATERIALS AND METHODS
Among 224 primary ACL reconstructions performed from January 2004 to May 2008 we examined in this study 38 patients who underwent a SB-ACL reconstruction and 30 patients underwent a DB-ACL reconstruction. They were followed up over 1 year. The evaluation methods were the Lachman test, pivot-shift test and KT-1000 measurement for knee stability and the Lysholm score and International Knee Documentation Committee (IKDC) ratings for the functional results. Tunnel enlargement was measured at the sclerotic ridge of the most widest area on the anteroposterior and lateral radiographs in longitudinal and vertical axis of the tunnel.
RESULTS
The tunnel enlargement on the femoral side was similar in the DB-ACL group and the SB-ACL group. On the other hand, on the tibial side, the tunnel enlargement was less in the DB-ACL group than in the SB-ACL group (p=0.001, ICC: 0.94). The two groups showed different functional results and extent of stability recovery. The KT-1000 arthrometer revealed 1.1 mm and 93% of negative in the pivot-shift test for the DB-ACL group, which induced an improved tendency compared to the SB-ACL group. No correlation was found between the tunnel enlargement and clinical results.
CONCLUSION
A DB-ACL reconstruction results in less tunnel enlargement on the tibial side than a SB-ACL reconstruction. There was no correlation between the tunnel enlargement and clinical results.

Keyword

anterior cruciate ligament; reconstruction; single-bundle; double-bundle; tunnel enlargement

MeSH Terms

Anterior Cruciate Ligament
Anterior Cruciate Ligament Reconstruction
Axis, Cervical Vertebra
Hand
Humans
Knee

Figure

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  Figure 1 The measurement of the tunnel enlargement. (A, B) Anteroposterior and lateral views of the single-bundle anterior cruciate ligament reconstruction group. (C, D) Anteroposterior and lateral views of the double-bundle anterior cruciate ligament reconstruction group.

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  Figure 2 Serial Changes of tunnel enlargement according to timeline on femur. SB, single bundle; AMB, anteromedial bundle; PLB, posterolateral bundle.

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  Figure 3 Serial Changes of tunnel enlargement according to timeline on tibia. SB, single bundle; AMB, anteromedial bundle; PLB, posterolateral bundle.

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