Santa Casa de São Paulo, Faculty of Medical Sciences, São Paulo, Brazil.
Int Orthop. 2012 Jul;36(7):1479-85; discussion 1539-41. doi: 10.1007/s00264-012-1488-7. Epub 2012 Feb 10.
The study is a prospective case-series analysis to demonstrate a new double bundle technique for anterior cruciate ligament (ACL) reconstruction with the use of hamstring tendons through a single tibial tunnel, a double femoral socket with implant-free femoral fixation and interference screw for tibial fixation.
Twenty-one patients were treated with the same technique. Hamstring tendons were not removed from the tibial side, and using a single tibial and a double femoral tunnel of 8 and 6 mm, respectively, anatomic ACL reconstruction was performed. Graft passage was performed from the tibial side to the posterolateral femoral tunnel and was looped back to the anteromedial femoral tunnel to be fixed on the tibial tunnel with an interference screw and additional extracortical fixation. Follow-up of the study group was performed for a two-year period, documenting standard clinical and radiographic parameters.
Post-operative follow-up (mean 24 months) revealed radiological widening of tibial tunnel (mean 133.6%) in all patients and minor femoral tunnels widening (119.4% and 117.5%). Clinical evaluation showed no signs of instability, and knee evaluation using the IKDC score was performed.
The manuscript describes a novel technique in ACL reconstruction, and reports the radiographic results of tunnel widening and clinical scores. Implant-free femoral fixation led to minor tunnel widening similar to previously published data. Further studies need to be performed to compare the long-term results with different published techniques of cost-effective implant-free ACL reconstruction.
本研究是一项前瞻性病例系列分析，旨在展示一种新的双束技术，用于前交叉韧带（ACL）重建，使用肌腱移植物通过单个胫骨隧道、双股骨套接且无植入物固定股骨、胫骨采用干扰螺钉固定。
21 例患者采用相同技术治疗。肌腱不从胫骨侧取出，分别使用 8mm 和 6mm 的单个胫骨和双股骨隧道，进行解剖 ACL 重建。移植物从胫骨侧进入后外侧股骨隧道，并绕回前内侧股骨隧道，用干扰螺钉和额外的皮质外固定在胫骨隧道上固定。对研究组进行为期两年的随访，记录标准的临床和影像学参数。
所有患者术后（平均 24 个月）均出现胫骨隧道的放射学增宽（平均 133.6%）和轻微的股骨隧道增宽（119.4%和 117.5%）。临床评估无不稳定迹象，使用 IKDC 评分进行膝关节评估。
本文描述了一种新的 ACL 重建技术，并报告了隧道增宽和临床评分的影像学结果。无植入物固定股骨导致轻微的隧道增宽，与先前发表的数据相似。需要进一步研究以比较不同微创、无植入物 ACL 重建技术的长期结果。
