Double-bundle versus single-bundle anterior cruciate ligament reconstruction with allogeneic tendon via single femoral tunnel
10.3969/j.issn.2095-4344.2017.34.018
- VernacularTitle:同种异体肌腱双束单隧道及单束单隧道重建膝关节前交叉韧带
- Author:
Yang SONG
1
;
Huan JIANG
;
jun Qing DU
;
qiang Ding OU
;
guang Ming HUANG
;
tao Qiu ZENG
Author Information
1. 佛山市顺德区第一人民医院骨外科
- From:
Chinese Journal of Tissue Engineering Research
2017;21(34):5519-5525
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND: The anterior cruciate ligament (ACL) is an extremely important static structure that stabilizes the structure of the knee joint. Many scholars have found that an insufficient understanding of normal anatomical structure and biological characteristics of the ACL results in poor outcomes in the ACL reconstruction. OBJECTIVE: To compare the clinical effects of single-bundle and double-bundle single-tunnel techniques in ACL reconstruction with allogeneic tendon. METHODS: (1) Anatomy research: Six fresh knee joints were used for the experiments, and X-ray, CT and MRI were taken for each sample to confirm no osteoclasia, tumor and collapse of ACL. Then the ACL was stripped from the tibial bone and used to run hematoxylin-eosin staining and observe the fiber distribution of each piece of the ACL. (2) Clinical research: A total of 40 cases of ACL arthroscopic reconstruction were involved in this study, including 19 single-bundle ones and 21 double-bundle ones. The International Knee Documentation Committee 2000 subjective knee form (IKDC2000), Tegner and Lysholm evaluations were performed in all the patients. Paired t-test was used to analyze the IKDC, Tegner and Lysholm scores before operation and at follow-up time. RESULTS AND CONCLUSION: Anatomy research: From the view of anatomy, there was no evidence to support the double beams of the ACL at the tibial end by hematoxylin-eosin staining. Clinical research: Forty patients (40 knee joints) were successfully followed for over 12 months, and their joint range of motion was normal. The IKDC, Tegner and Lysholm scores were all improved in both two groups after the surgery, while the Larson scores were significantly higher in the double-bundle group than the single-bundle group. To conclude, the single-tunnel double-bundle ACL reconstruction is better to restore the knee stability than the single-bundle ACL reconstruction. This is an easy operation that has the merits of operating conveniently, restoring the normal anatomy of the tibial end, and exhibiting excellent short-term therapeutic effects. However, its long-term effects are uncertain.
