Comparative Analysis of Double Bundle and Single Bundle ACL Reconstruction with Tibialis Anterior Allograft

동종건을 이용한 단일다발 및 이중다발 전방십자인대 재건술의 비교 분석

  • Kim, Deok-Weon (Department of Orthopedic Surgery, Inje University Seoul Paik Hospital) ;
  • Lee, Kang (Department of Orthopedic Surgery, Inje University Seoul Paik Hospital) ;
  • Kim, Young-Woo (Department of Orthopedic Surgery, Inje University Seoul Paik Hospital) ;
  • Yang, Sang-Jin (Sports Medical Center, Inje University Seoul Paik Hospital) ;
  • Seo, Jeong-Gook (Department of Orthopedic Surgery, Inje University Seoul Paik Hospital) ;
  • Kim, Jin-Goo (Department of Orthopedic Surgery, Inje University Seoul Paik Hospital)
  • 김덕원 (인제대학교 의과대학 서울백병원 정형외과학교실) ;
  • 이강 (인제대학교 의과대학 서울백병원 정형외과학교실) ;
  • 김영우 (인제대학교 의과대학 서울백병원 정형외과학교실) ;
  • 양상진 (인제대학교 의과대학 서울백병원 스포츠메디컬센터) ;
  • 서정국 (인제대학교 의과대학 서울백병원 정형외과학교실) ;
  • 김진구 (인제대학교 의과대학 서울백병원 정형외과학교실)
  • Published : 2008.10.29

Abstract

Purpose: The purpose of this study is to analyze the merits and demerits of double bundle reconstruction and achieve improvements hereafter, by comparing the results of double bundle and single bundle reconstruction using tibialis anterior allograft. Materials and Methods: Twenty seven patients were divided to undergo either double bundle(n=14) or single bundle(n=13) reconstruction with tibialis anterior allograft tendon. The evaluation methods were AP laxity with KT-2000 arthrometer, isokinetic knee strength measurements, pivot-shift test, IKDC subjective score, Lysholm knee score, Tegner activity score, radiographic evaluations with postoperative MRI, and second look arthroscopy. Results: Lysholm knee score and Tegner activity score were significantly better in double bundle reconstruction. In pivot-shift test, single bundle reconstruction was evaluated as grade 0 in 10 of the knees, grade 1 in 1, and grade 2 in 2. Double bundle reconstruction was evaluated as grade 0 in 13, and grade 2 in 1. In second look arthroscopy, single bundle was evaluated as excellent in 6 of the knees, fair in 7, anteromedial bundle of double bundle reconstruction was excellent in 13 and fair in 1, and posterolateral bundle was excellent in 4, fair in 9, and poor in 1. There were no significant differences in other evaluations. Conclusion: Favorable outcome may be expected with double bundle reconstruction of ACL. However there are still need for improvement in terms of reconstruction technique and rehabilitation protocol to reduce PL bundle injury.