• Title/Summary/Keyword: Single bundle anterior cruciate ligament reconstruction

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Clinical Review in Double-Bundle Anterior Cruciate Ligament Reconstruction (이중 다발 전방십자인대 재건술의 임상적 결과)

  • Lee, Ju-Hong
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.111-114
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    • 2009
  • Double-bundle anterior cruciate ligament reconstruction (DBACLR) has been developed to produce better clinical outcomes in traditional single-bundle reconstruction, which showed considerable rate of dissatisfaction in restoration of stability and function of the anterior cruciate ligament deficient knee. There is plenty of evidence that DBACLR has theoretical advantages in anatomical, biomechanical, biological, kinematical, and possibly clinical standpoint compared with traditional one but still a lack of available clinical outcome studies with sufficient follow-up to demonstrate the substantial advantages of DBACLR. The purpose of this article is to review the clinical outcomes of double-bundle technique and to address controversy exists over the usefulness of this technique.

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What Has Been Learned in Anterior Cruciate Ligament Reconstruction during the Past 20 Years? (전방십자인대 재건수술은 지난 20년간 어떻게 발전하였나?)

  • Ro, Du Hyun;Han, Hyuk-Soo;Lee, Myung Chul
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.1-13
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    • 2021
  • Considerable progress on anterior cruciate ligament reconstruction surgery has been made over the past 20 years, and the results have improved significantly. An anatomical understanding of the anterior cruciate ligament has also changed, and the surgical technique has also changed accordingly. The double-bundle concept is still valid, but the ribbon-shaped anterior cruciate ligament concept, including direct fiber and indirect fiber, is gradually replacing it. The isometry point theory no longer exists, and various surgical methods, such as single-bundle anatomical reconstruction, double-bundle reconstruction, remnant preservation, and rectangular tunnel technique, are being performed. Regarding the graft, interest in the bone-patellar tendon-bone, patellar tendon, quadriceps tendon, and allogeneic tendon change over time, and this change is ongoing.

Two-Bundle Anterior Cruciate Ligament Reconstruction with Single Femoral Tunnel and Tibialis Anterior Tendon Allograft (단일 대퇴 터널과 전경골 동종건을 이용한 이중 다발 전방십자인대 재건술)

  • Kim, Yeung-Jin;Chae, Soo-Uk;Yang, Jung-Hwan;Lee, Ji-Wan;Shim, Sung-Woo
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.2
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    • pp.107-113
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    • 2010
  • Purpose: To evaluate the outcome of the two-bundle anterior cruciate ligament reconstruction with single femoral tunnel and tibialis anterior tendon allograft and to determine any functional advantages. Materials and Methods: From June 2006 to March 2008, we performed single femoral tunnel and two-bundle ACL reconstruction with tibialis anterior tendon allograft in 26 cases. Mean age was 35.5 years. 20 cases were male and 6 cases were female. Average follow-up period was 2 years and 5 months, range from 1 year to 3 years and 5 months. Subjective and objective parameters were utilized in analyses, such as the mean range of motion, Lysholm knee score, Tegner activity score, Lachman test and IKDC score. Results: Postoperative mean Lysholm knee score, IKDC Evaluation Form, Tegner activity scale, Pivot shift test, and anterior displacement by the Telos stress test demonstrated statistically significant differences compared to the preoperative. Conclusion: Two-bundle anterior cruciate ligament reconstruction with single femoral tunnel showed good clinical results and was good operative technique.

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Single Bundle PCL Reconstruction with Remnant Preservation (잔여 조직을 보존한 단일 다발 후방십자인대 보강재건술)

  • Lee, Dong Chul;Kim, Won-Ho
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.2
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    • pp.125-131
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    • 2011
  • Optimal treatment of the torn posterior cruciate ligament (PCL) remains controversial. The type of tibial fixation (transtibial vs inlay), the femoral tunnel position within the femoral footprint (central, eccentric or isometric), and the number of bundles in the reconstruction (single-bundle vs double-bundle) are controversial issues. The PCL has a better chance of spontaneously healing than the anterior cruciate ligament (ACL) because of a rich blood supply (near the branch of the middle genicular artery) and coverage with a thicker synovium. In general, for easier passage of the graft and full visualization of the original ligament attachment site during the precise positioning of the tunnel, the remaining PCL fibers are usually debrided during reconstruction. However, the remaining remnant structures would significantly contribute to the posterior stability of the knee joint, the healing of the graft, preserving proprioceptive function of the mechanoreceptors in the PCL. Double bundle PCL reconstruction may result in some surgical complications because of increased complexity of making tunnel. Therefore, single bundle PCL reconstruction with remnant preservation seems to be an effective procedure.

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Current Concepts in Reconstruction of Anterior Cruciate Ligament (전방십자인대 재건술의 경향)

  • Yoon, Kyoung Ho
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.12 no.1
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    • pp.1-7
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    • 2013
  • This article provides an overview of the current concepts regarding anterior cruciate ligament reconstruction, including anatomy, biomechanics, operative techniques and clinical results. Many techniques have been introduced for ACL reconstruction: single bundle reconstruction, remnant preserving augmentation, and double bundle reconstruction. Each technique has its strong and weak points, and it is not sure which technique is superior than others. It is considered to suggest that rather than to select the same method of surgery in all patients, select the method of reconstruction depending on the characteristics of the individual patient, the state of the residual ligaments and extent of the damage.

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Effect of Lateral and Posterior Placement of Single-Bundle and Double-Bundle ACL Reconstructions on Tibial Internal Rotation During Single-Leg Landing (전방십자인대 한다발재건술의 후외측다발 재건 및 두다발재건술이 외발착지 동작 시에 경골내회전에 미치는 영향)

  • Shin, Choong-Soo
    • Transactions of the Korean Society of Mechanical Engineers A
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    • v.35 no.5
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    • pp.517-523
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    • 2011
  • Anterior cruciate ligament (ACL) injuries are treatedwith surgical reconstruction. Although ACL consists of two functional bundles, only the anteromedial bundle is surgically reconstructed, and the effect of the reconstruction of the posterolateral bundle is unknown. The purpose of this study is to investigate the role of the posterolateral bundle and the effect of double-bundle reconstruction during single-leg landing. A 3D dynamic knee with various ACL reconstructed models was created using MRI, and single-leg landing motion was simulated using in-vivo human experimental data. The results showed that the lateral shift of the tibial insertion of the anteromedial bundle and the posterolateral bundle of the ACL constrain the tibial internal rotation more efficiently than a single anteromedial bundle can. In addition, double-bundle ACL reconstruction is less sensitive to inaccuracies in the tibial tunnel placement.

Double-Bundle Anterior Cruciate Ligament Reconstruction (이중 다발 전방십자인대 재건술)

  • Kim, Jae-Hwa;Kim, Jung Ryul
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.2
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    • pp.132-139
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    • 2011
  • The concept of double-bundle ACL reconstruction was introduced recently to restore the anatomical and biomechanical functions of the native ACL. According to anatomical and biomechanical studies, the separate reconstruction of anteromedial and posterolateral bundle expect to increase the overall postoperative stability and clinical results compared to single-bundle ACL reconstruction. But there is still a lack of available clinical outcome studies with sufficient follow-up to demonstrate the real advantages of double-bundle ACL reconstruction. The purpose of this article is to review the evidence to support double-bundle technique and to address controversies existing over the usefulness of this technique.

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Clinical Outcomes after the Anatomic Single Bundle Anterior Cruciate Ligament Reconstruction Using Outside-in Technique (Outside-in 술기를 이용한 해부학적 단일 다발 전방십자인대 재건술의 임상적 결과)

  • Sohn, Myung-Whan;Kim, Jeong-Tae;Seo, Seung-Suk;Seo, Jin-Hyeok;Kim, Chang-Wan
    • Journal of the Korean Arthroscopy Society
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    • v.17 no.1
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    • pp.18-23
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    • 2013
  • Purpose: The purpose of this study is to evaluate the usefulness of anatomical single bundle anterior cruciate ligament (ACL) reconstruction using outside-in technique by clinical outcome analysis. Materials and Methods: From July 2009 to July 2010, 41 cases of single bundle ACL reconstruction using outside-in technique which were followed minimum 1 year were enrolled. Clinical results were evaluated using International Knee Documentation Committee (IKDC) subjective knee evaluation score, Lysholm score, pivot shift test, one leg hop test, KT-1000 arthrometer test, Telos stress arthrometer test. Results: IKDC subjective knee score and Lysholm score were improved to $86.1{\pm}2.1$ and $91.2{\pm}3.8$ postoperatively (p<0.0001 and p<0.0001, respectively). KT-1000 arthrometer test and Telos stress arthrometer test also were improved to $2.2{\pm}0.9\;mm$ and $2.3{\pm}1.2\;mm$ (p<0.0001 and p<0.0001, respectively). Pivot shift test and one leg hop test revealed good results. Conclusion: Anatomical single bundle anterior cruciate ligament reconstruction using outside-in technique showed good clinical results, so it was considered available method.

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