Lorenzo Moretti, Raffaele Garofalo, Giuseppe Danilo Cassano, Roberto Calbi, Francesco Fiore, Giuseppe Solarino
Department of Translational Biomedicine and Neuroscience (DiBraiN), Orthopaedic and Trauma Unit, AOUC Policlinico di Bari University of Bari "Aldo Moro" Bari Italy.
Department of Orthopaedics and Traumatology Ente Ecclesiastico Ospedale "F. Miulli" Acquaviva delle Fonti Bari Italy.
J Exp Orthop. 2025 Feb 27;12(1):e70100. doi: 10.1002/jeo2.70100. eCollection 2025 Jan.
The aim of the present study was to compare clinical and radiological outcomes between the all-inside single bundle (SB) and a modified double-bundle (DB) anterior cruciate ligament reconstructions (ACLR) at over 5-year follow-up.
This is an observational, retrospective comparative, two-centre study. Clinical outcomes were evaluated using Lysholm and International Knee Documentation Committee (IKDC) scores, and anterior tibial translation (ATT) was assessed using the KT-1000 arthrometer. Knee x-ray images were recorded, classified according to the KL grading and compared with radiographs of the same patient before surgery. Inclusion criteria were patients undergoing ACLR, age between 18 and 45 years and negative knee history of major traumatic events after surgery. Exclusion criteria were congenital laxity, combined multiple knee ligament injuries, patients undergoing ACL revision surgery, history of infection, lower limb coronal axial deviation >5°, patients undergoing lateral extra-articular tenodesis or anterolateral ligament reconstruction, patients with chondral damage Outerbridge grade >2, patients with meniscal tears undergoing subtotal meniscectomy or meniscal repair and patients with knee OA Kellgren-Lawrance (KL) grade >3.
One hundred and fifty-two patients were included in the study. Patients were divided into two groups according to surgical technique: Group A-ACLR with all-inside technique, and Group B-ACLR with modified DB technique. There were no statistical differences between groups for age, side, gender or time since surgery.There were no statistically significant differences between groups for Lysholm scores ( = 0.43), IKDC ( = 0.88), ATT ( = 0.105) and KL grade ( = 0.93 before surgery, 0.99 at the fu). KL grade increased significantly since pre-op.
Our data show significant improvements in all clinical outcome measures, along with excellent KT-1000 arthrometer values and low clinical failure rates for both the SB all-inside and modified DB techniques at a mean follow-up of over 6 years. There were no significant differences in arthritic progression according to KL grade between groups.
Level III.
本研究旨在比较全关节镜下单束（SB）和改良双束（DB）前交叉韧带重建术（ACLR）在5年以上随访期的临床和影像学结果。
这是一项观察性、回顾性比较、双中心研究。使用Lysholm评分和国际膝关节文献委员会（IKDC）评分评估临床结果，使用KT-1000关节测量仪评估胫骨前移（ATT）。记录膝关节X线图像，根据KL分级进行分类，并与患者术前的X线片进行比较。纳入标准为接受ACLR手术的患者，年龄在18至45岁之间，术后无重大创伤事件的膝关节病史。排除标准为先天性松弛、合并多根膝关节韧带损伤、接受ACL翻修手术的患者、感染史、下肢冠状轴向偏差>5°、接受外侧关节外肌腱固定术或前外侧韧带重建术的患者、软骨损伤Outerbridge分级>2的患者、半月板撕裂接受半月板次全切除术或半月板修复的患者以及膝关节骨关节炎Kellgren-Lawrance（KL）分级>3的患者。
152例患者纳入研究。根据手术技术将患者分为两组：A组——采用全关节镜技术的ACLR，B组——采用改良DB技术的ACLR。两组在年龄、患侧、性别或术后时间方面无统计学差异。两组在Lysholm评分（=0.43）、IKDC评分（=0.88）、ATT（=0.105）和KL分级（术前=0.93，随访时=0.99）方面无统计学显著差异。自术前以来，KL分级显著增加。
我们的数据显示，在平均超过6年的随访中，SB全关节镜技术和改良DB技术在所有临床结果指标上均有显著改善，同时KT-1000关节测量仪值优异，临床失败率低。两组之间根据KL分级的关节炎进展无显著差异。
三级。
