Purpose: To compare the clinical outcome of anatomic double-bundle anterior cruciate ligament (ACL) reconstruction with that of nonanatomic single- and double-bundle reconstructions. Type of Study: Prospective comparative cohort study. Methods: Seventy-two patients with unilateral ACL-deficient knees were randomly divided into 3 groups. Concerning all background factors, there were no statistical differences among the 3 groups. In group S (n = 24), single-bundle ACL reconstruction was performed. In group N-AD (n = 24), nonanatomic double-bundle reconstruction was carried out. In group AD (n = 24), anatomic double-bundle reconstruction was performed. One surgeon performed all operations using hamstring tendon autografts. Each patient underwent clinical examinations, before surgery and at 2 years. Results: No intraoperative and postoperative complications were experienced in each group. There were no significant differences concerning the time for operation among the 3 groups. The statistical analysis showed a significant difference in the postoperative side-to-side anterior laxity among the 3 groups (P = .006). The laxity was significantly less (P = .002) in group AD (1.1 mm) than in group S (2.8 mm), while there was no significant difference (P = .072) between groups AD and N-AD. Concerning the pivot-shift test, group AD was significantly superior to group S (P = .025). There were no significant differences in the range of knee motion, the muscle torque, and the International Knee Documentation Committee evaluation. Conclusions: On the basis of the KT-2000 measurement, the side-to-side anterior laxity of our anatomic double-bundle ACL reconstruction was significantly better than that of the single-bundle reconstruction with the hamstring tendon graft, although there were no significant differences in the other clinical measures among any of the 3 procedures. Level of Evidence: Level II.
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NOTE: To access the supplementary table accompanying this report, visit the March issue of Arthroscopy at www.arthroscopyjournal.org
Supported in part by a Grant-in-Aid for Scientific Research (No. 16390425) from the Ministry of Education, Science and Culture of Japan. Presented in part at the Biennial Congress of the International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine, Hollywood, Florida, March 2005.
© 2006 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.