Single-Tunnel Double-Bundle Anterior Cruciate Ligament Reconstruction with Anatomical Placement of Hamstring Tendon Graft

Hemanth R. Gadikota, Jia Lin Wu, Keun Seon Jong Keun Seon, Karen Sutton, Thomas J. Gill, Guoan Li

研究成果: 雜誌貢獻文章同行評審

28 引文 斯高帕斯(Scopus)

摘要

Background: Anatomical reconstruction techniques that can restore normal joint kinematics without increasing surgical complications could potentially improve clinical outcomes and help manage anterior cruciate ligament injuries more efficiently. Hypothesis: Single-tunnel double-bundle anterior cruciate ligament reconstruction with anatomical placement of hamstring tendon graft can more closely restore normal knee anterior-posterior, medial-lateral, and internal-external kinematics than can conventional single-bundle anterior cruciate ligament reconstruction. Study Design: Controlled laboratory study. Methods: Kinematic responses after single-bundle anterior cruciate ligament reconstruction and single-tunnel double-bundle anterior cruciate ligament reconstruction with anatomical placement of hamstring tendon graft were compared with the intact knee in 9 fresh-frozen human cadaveric knee specimens using a robotic testing system. Kinematics of each knee were determined under an anterior tibial load (134 N), a simulated quadriceps load (400 N), and combined torques (10 N·m valgus and 5 N·m internal tibial torques) at 0°, 15°, 30°, 60°, and 90° of flexion. Results: Anterior tibial translations were more closely restored to the intact knee level after single-tunnel double-bundle reconstruction with anatomical placement of hamstring tendon graft than with a single-bundle reconstruction under the 3 external loading conditions. Under simulated quadriceps load, the mean internal tibial rotations after both reconstructions were lower than that of the anterior cruciate ligament - intact knee with no significant differences between these 3 knee conditions at 0° and 30° of flexion (P >.05).The increased medial tibial shifts of the anterior cruciate ligament - deficient knees were restored to the intact level by both reconstruction techniques under the 3 external loading conditions. Conclusion: Single-tunnel double-bundle anterior cruciate ligament reconstruction with anatomical placement of hamstring tendon graft can better restore the anterior knee stability compared with a conventional single-bundle reconstruction. Both reconstruction techniques are efficient in restoring the normal medial-lateral stability but overcorrect the internal tibial rotations. Clinical Relevance: Single-tunnel double-bundle anterior cruciate ligament reconstruction with anatomical placement of hamstring tendon graft could provide improved clinical outcomes over a conventional single-bundle reconstruction.

原文英語
頁(從 - 到)713-720
頁數8
期刊American Journal of Sports Medicine
38
發行號4
DOIs
出版狀態已發佈 - 4月 1 2010
對外發佈

ASJC Scopus subject areas

  • 骨科和運動醫學
  • 物理治療、運動療法和康復

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