Reply to the comments by Dr. Ozer et al. on our article "Anatomic double-bundle ACL reconstruction with femoral cortical bone bridge support using hamstrings"
- Knee Surgery Sports Traumatology Arthroscopy 07/2009; 17(8):1006-7; author reply 1008-9. DOI:10.1007/s00167-009-0840-y · 2.84 Impact Factor
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ABSTRACT: Current techniques for anterior cruciate ligament (ACL) reconstruction do not completely reproduce the anatomy and function of the ACL. They address only the anteromedial bundle and do not fully restore ACL function throughout the range of motion. Current grafts control anterior tibial subluxation near extension, but are less efficacious in providing rotatory stability. Recently, several authors have suggested reconstructing not just the anteromedial bundle but also the posterolateral bundle. This technical note describes a double-bundle ACL reconstruction using hamstring tendons routed through 2 tibial and 2 femoral independent tunnels.Arthroscopy The Journal of Arthroscopic and Related Surgery 11/2004; 20(8):890-4. DOI:10.1016/j.arthro.2004.06.019 · 3.19 Impact Factor
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ABSTRACT: The objective of the study was to retrospectively compare the clinical outcomes of anatomic double-bundle anterior cruciate ligament reconstruction via hamstring tendons with single-bundle reconstruction between April 2002 and March 2004. We retrospectively reviewed 123 consecutive patients, 71 of whom underwent double-bundle reconstruction and 52 of whom underwent single-bundle reconstruction. The same postoperative rehabilitation protocol was used for all patients. The patients were followed up for a mean of 33 months. We evaluated manual knee laxity, anterior knee laxity as measured with the KT1000 arthrometer (MEDmetric, San Diego, CA), range of knee motion, isokinetic peak torque of knee extension and flexion strength adjusted for body weight as determined by Cybex testing (Lumex, Ronkonkoma, NY), and Lysholm score. The Lachman test was negative in 64 cases (90%) and the pivot-shift test was negative in 62 cases (87%) in the double-bundle group. The Lachman test was negative in 45 cases (86%) and the pivot-shift test was negative in 42 cases (81%) in the single-bundle group. There was an extension deficit of greater than 5 degrees in 19 cases (26%) in the double-bundle group and 6 cases (10%) in the single-bundle group (P < .05). The side-to-side difference in anterior tibial translation measured with the KT1000 arthrometer was 1.7 +/- 2.0 mm in the double-bundle group and 1.9 +/- 2.2 mm in the single-bundle group. The isokinetic peak torque of knee extension and flexion strength was 90% and 89%, respectively, in the double-bundle group and 87% and 86%, respectively, in the single-bundle group. The Lysholm score averaged 96.8 +/- 5.1 in the double-bundle group and 92.8 +/- 6.9 in the single-bundle group postoperatively. No significant difference was found between the 2 procedures with regard to manual knee laxity, anterior knee laxity measured by the KT1000 arthrometer, knee extension and flexion strength, and Lysholm score. In contrast, there was a significant difference in the range of knee motion between the 2 groups. The findings of our study do not support the routine adoption of double-bundle reconstruction. Level III, retrospective comparative study.Arthroscopy The Journal of Arthroscopic and Related Surgery 06/2007; 23(6):602-9. DOI:10.1016/j.arthro.2007.01.009 · 3.19 Impact Factor