Cermak K, Baillon B, Bruynseels K, Salvia P, Feipel V, Remy P, Vancabeke M, Rooze M
Service d'Orthopédie-Traumatologie, Cliniques Universitaires de Bruxelles, Hôpital Erasme, Bruxelles.
Rev Med Brux. 2011;32(6 Suppl):S90-6.
Anatomical and biomechanical studies have shown that the anterior cruciate ligament (ACL) consists of two distinct bundles, the anteromedial (AM) and posterolateral. Each bundle has its specific role during the motion of the knee. ACL reconstruction techniques have focused on the restauration of the anteroposterior stability by substituting the more isometric AM bundle. Although these ligamentoplasties provide overall good results, in the last ten years double-bundle ACL reconstruction techniques have been developed, to better replicate the ligament anatomy. Despite the growing number of published studies, including randomized controlled trials comparing single bundle and double bundle reconstructions, there is still a lack of evidence of any superiority of the double-bundle technique. Furthermore, many series are criticized for their poor assessement of rotational stability, using most of the time subjective pivot shift clinical testing. Among the methods available to measure tibial rotation, 3-D optoelectronic evaluation is an attractive tool and has been used in some studies reporting rotational mesurements after ACL single-bundle reconstruction. Our Department of Orthopaedics and Traumatology has been using double-bundle techniques for a few years. We conducted a preliminary prospective randomized study, in order to compare single and double-bundle techniques by clinical and optoelectronic evaluations.
解剖学和生物力学研究表明，前交叉韧带（ACL）由两个不同的束组成，即前内侧（AM）束和后外侧束。在膝关节运动过程中，每个束都有其特定作用。ACL重建技术一直专注于通过替代更等长的AM束来恢复前后稳定性。尽管这些韧带重建术总体效果良好，但在过去十年中，双束ACL重建技术得到了发展，以更好地复制韧带解剖结构。尽管已发表的研究数量不断增加，包括比较单束和双束重建的随机对照试验，但仍缺乏证据表明双束技术具有任何优越性。此外，许多系列研究因其对旋转稳定性评估不佳而受到批评，大多数时候使用主观的轴移临床测试。在可用于测量胫骨旋转的方法中，三维光电评估是一种有吸引力的工具，并且已在一些报告ACL单束重建后旋转测量的研究中使用。我们的骨创伤科已经使用双束技术数年。我们进行了一项初步的前瞻性随机研究，以便通过临床和光电评估比较单束和双束技术。
