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- Title
Outcome of anatomical double-bundle ACL reconstruction using hamstring tendons via an outside-in approach.
- Authors
Amano, Hiroshi; Toritsuka, Yukiyoshi; Uchida, Ryohei; Mae, Tatsuo; Ohzono, Kenji; Shino, Konsei
- Abstract
Purpose: To evaluate the clinical outcome of anatomical double-bundle anterior cruciate ligament (ACL) reconstruction using multistranded hamstring tendons via an outside-in approach. Methods: One hundred and twenty-one patients (mean age 28 ± 10 years) who underwent ACL reconstruction were examined. Using an outside-in femoral drill guide, an upper femoral tunnel for the anteromedial (AM) graft was created just below the superior articular cartilage margin of the medial wall of the lateral condyle through a small incision. A lower femoral tunnel for the posterolateral (PL) graft was drilled in the centre of the inferior-posterior half of the attachment area behind the resident's ridge in the same manner. Two tibial tunnels were created at the centre of the AM and PL bundle footprints of a normal ACL. Patients were evaluated at 24 months postoperatively. Results: According to the IKDC form, 52 knees (43 %) were graded as normal, 64 (53 %) as nearly normal, 1 (1 %) as abnormal and 4 (3 %) as graft rupture due to re-injury. Loss of knee extension of <5° was observed in one patient (1 %). Among 111 patients who were directly evaluated, none showed loss of flexion of <5°. Lachman sign was negative in 103 patients (93 %), while the pivot shift test result was negative or equivalent to that of the contralateral healthy knee in 103 patients (93 %). The mean side-to-side difference in anterior laxity at manual maximum force with the KT-2000 arthrometer was 0.9 ± 1.1 mm, and 94 % of patients showed a range between −1 and +2 mm. Conclusion: The anatomical double-bundle outside-in ACL reconstruction provided a satisfactory short-term outcome. Level of evidence: Case series, Level IV.
- Subjects
ANTERIOR cruciate ligament surgery; HAMSTRING muscle; ARTICULAR cartilage; RANGE of motion of joints; TIBIA; HEALTH outcome assessment; TRANSPLANTATION of organs, tissues, etc.
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2015, Vol 23, Issue 4, p1222
- ISSN
0942-2056
- Publication type
Article
- DOI
10.1007/s00167-014-2950-4