Ha Jeong-Ku, Lee Dhong-Won, Kim Jin-Goo
Department of Orthopedic Surgery, College of Medicine, Seoul Paik Hospital, University of Inje, Seoul, Korea.
Department of Orthopedic Surgery, Daejeon Military Hospital, Daejeon, Korea.
Indian J Orthop. 2016 Sep;50(5):505-511. doi: 10.4103/0019-5413.189605.
Numerous studies have elucidated the functional anatomy and biomechanics of the anterior cruciate ligament (ACL), as a result, double-bundle (DB) ACL reconstruction has received much attention and has become a popular choice because it gives better rotational stability. Many other studies, however, found no differences with respect to stability, and/or other clinical outcomes between the DB and single-bundle (SB) techniques. There is still not enough evidence as to whether the anatomical DB anterior cruciate ligament reconstruction (ACLR) is superior to anatomical SB reconstruction. The purpose of this study is to compare various clinical and functional outcomes between SB and DBACLR at 2 years followup.
Medical records of patients with ACLR available for at least 2 years followup were reviewed retrospectively. 191 patients (164 males and 25 females) for SB and 48 patients (40 males and 8 females) for DB were selected using the inclusion and exclusion criteria. The mean age of SB and DB was 29.9 and 24.8 years, respectively. Propensity score (PS) was calculated based on age, sex and Tegner activity score and 48 patients in each group were matched by the PS. Lysholm score, International Knee Documentation Committee (IKDC) subjective knee score and Tegneractivity score were investigated. Functional performance tests, isokinetic muscle strength test with Biodex system, pivot shift test and KT-2000 arthrometer test were performed.
At 2 years followup, there were no significant differences between SB and DB group in Lysholm score (92.9 vs. 90.6, = 0.224), IKDC subjective knee score (88.7 vs. 87.0, = 0.524), Tegner activity score (7.3 vs. 8.0, = 0.059). No significant differences were also found in all functional performance tests, isokinetic muscle strength tests in 60° and 180°/s, KT-2000 arthrometer test and pivot shift test ( > 0.05).
There were no significant differences of clinical and functional outcomes between SB and DB ACLR at 2 years followup.
众多研究已阐明前交叉韧带（ACL）的功能解剖学和生物力学，因此，双束（DB）ACL重建备受关注并成为一种流行选择，因为它能提供更好的旋转稳定性。然而，许多其他研究发现，DB技术与单束（SB）技术在稳定性和/或其他临床结果方面并无差异。关于解剖学双束前交叉韧带重建（ACLR）是否优于解剖学单束重建，仍没有足够的证据。本研究的目的是比较SB和DB-ACLR在2年随访时的各种临床和功能结果。
回顾性分析至少有2年随访资料的ACLR患者的病历。根据纳入和排除标准，选择191例接受SB手术的患者（164例男性和25例女性）和48例接受DB手术的患者（40例男性和8例女性）。SB组和DB组的平均年龄分别为29.9岁和24.8岁。根据年龄、性别和Tegner活动评分计算倾向得分（PS），并按PS对每组4位患者进行匹配。调查Lysholm评分、国际膝关节文献委员会（IKDC）主观膝关节评分和Tegner活动评分。进行功能性能测试、使用Biodex系统的等速肌力测试、轴移试验和KT-2000关节测量仪测试。
在2年随访时，SB组和DB组在Lysholm评分（92.9对90.6，P = 0.224）、IKDC主观膝关节评分（88.7对87.0，P = 0.524）、Tegner活动评分（7.3对8.0，P = 0.059）方面均无显著差异。在所有功能性能测试、60°和180°/秒的等速肌力测试、KT-2000关节测量仪测试和轴移试验中也未发现显著差异（P>0.05）。
在2年随访时，SB和DB ACLR在临床和功能结果方面无显著差异。
