• 대한관절경학회:학술대회논문집
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• 2009.10a
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• pp.130-130
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• 2009

• Journal of the Korean Arthroscopy Society
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• v.14 no.1
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• pp.13-19
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• 2010

Purpose: To evaluate and compare the postoperative knee stability and functional scores between single- and double- bundle anterior cruciate ligament (ACL) reconstruction at a minimum 2 years follow-up. Materials and Methods: 56 patients (group T) with ACL injury in one knee were recruited with 27 allocated to the double bundle ACL reconstruction group (group D) and 29 to the single bundle ACL reconstruction group (group S). Clinical outcomes including Lysholm knee scores, Tegner activity scores, Lachman and pivot shift test results, and radiographic stabilities were also compared between two groups. Results: Clinical outcomes including Lysholm knee and Tegner activity scores were similar in the two groups at 2 years follow-up. Furthermore, stability results of Lachman test, pivot shift test, and radiological findings failed to reveal any significant inter-group differences. Conclusion: Double bundle ACL reconstruction does not produce better in clinical outcomes and postoperative stabilities.

• Journal of the Korean Orthopaedic Association
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• v.55 no.4
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• pp.311-317
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• 2020

The most recent concept in anterior cruciate ligament reconstruction is an anatomical single bundle anterior cruciate ligament reconstruction. For an anatomical anterior cruciate ligament reconstruction, the tibial tunnel is made anterior than before, and the femoral tunnel is made in a lower and oblique direction compared to the classical method using the transtibial technique. The anteromedial portal technique, outside-in technique, and modified transtibial technique have been performed to produce femoral tunnels with anatomical positions. Each method has different advantages and disadvantages and is chosen based on the operator's preferences, experience, instruments, and implants.

• Journal of the Korean Arthroscopy Society
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• v.11 no.2
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• pp.92-98
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• 2007

Purposes: The purpose of this study was to report surgical technique of double bundle anterior cruciate ligament(ACL) reconstruction and to compare the short-term clinical results between arthroscopic single-bundle and double-bundle ACL reconstruction. Materials and Methods: From May 2005 to May 2006, ninety-eight patients were underwent ACL reconstruction. We designed prospective study with sixty-one patients who were revealed isolated ACL injury. We serially checked clinical and radiologic data preoperatively and postoperatively. We compared single-bundle with double-bundle ACL reconstruction patients with preoperative datas and postoperatively 1-year data. There were 30 single bundle reconstruction and 31 double bundle reconstruction. Stability was assessed objectively by anterior stress radiographs with the $Telos^{(R)}$ device and the maximal manual test with the KT-2000 arthrometer. The clinical results were assessed by IKDC(International Knee Documentation Committee) and OAK(Orthopadische Arbeitsgruppe Knie) scores. Also, we evaluated postoperative thigh circumference and range of motion. All of operations were done by only one surgeon. Results: At single-bundle reconstruction group, preoperative AP instability which was checked by $Telos^{(R)}$ device and the maximal manual test with the KT-2000 arthrometer was $7.9{\pm}3.3$ and $7.4{\pm}2.0$, respectively. At double-bundle reconstruction group, it was $8.3{\pm}3.5$ and $7.9{\pm}3.2$, respectively. Residual AP laxity checked at 1 year after operation was $1.9{\pm}1.2$ and $2.2{\pm}1.6$ in single-bundle reconstruction group, and $1.1{\pm}0.9$ and $1.0{\pm}1.0$ in double-bundle reconstruction group. So, double-bundle reconstruction had better results in both anterior stress radiographs with the $Telos^{(R)}$ device and the maximal manual test with the KT-2000 arthrometer, and there were significant differences in statistics. But, clinical results such as IKDC(International Knee Documentation Committee) scores, OAK(Orthopadische Arbeitsgruppe Knie) scores, thigh circumference and range of motion had no significant difference between two groups. Conclusions: On the basis of stability, the side-to-side anterior laxity of double-bundle ACL reconstruction was significantly better than that of single-bundle reconstruction, although there were no significant differences in the other clinical measures among them.

• 대한관절경학회:학술대회논문집
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• 2008.04a
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• pp.14-14
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• 2008

• 대한관절경학회:학술대회논문집
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• 2008.04a
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• pp.12-13
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• 2008

• Journal of the Korean Arthroscopy Society
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• v.16 no.2
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• pp.107-113
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• 2012

Purpose: The purpose of this study was to evaluate the posterior cruciate ligament (PCL) reconstruction with single bundle, single-incision technique using Achilles tendon and tibialis anterior allograft with ligament remnant preservation. Materials and Methods: Twenty six patients underwent PCL reconstruction was included. There were 21 males and 5 females. Mean age was 32 years. Used graft was a fresh frozen Achilles tendon allograft (group I, 14 cases) and tibialis anterior allograft (group II, 12 cases). Arthroscopic PCL reconstruction was performed using transtibial, single-incision and single bundle technique with remnant preserving as possible. For clinical evaluation, range of motion, posterior drawer test, Lysholm score, Tegner activity scale, International Knee Documentation Committee (IKDC) grade and posterior stress radiograph were used. The mean follow-up period was 21.6 months (12-40 months). Associated injuries were 5 medial collateral ligament injuries, which were treated by conservative method. Results: Range of motion (ROM) was returned to normal range in 24 cases, but ROM deficit under $10^{\circ}$ flexion was 2 cases at final follow-up period. Preoperative posterior drawer test was 17 cases in grade II and 9 cases in grade III. At final follow-up 13 cases returned within normal grade, 7 cases grade I and 6 cases grade II posterior instability. Lysholm mean score was improved from preoperatively 62 to 90 at final follow-up period. Tegner activity mean scale improved from preoperatively 3.5 to 5.6 at final follow-up period. IDKC grade was grade A was 3 cases, grade B 17 cases, grade C 6 cases. In posterior stress radiograph, posterior displacement was improved from mean 12 mm preoperative to 4.5 mm at final follow-up. There were no statistical differences between two groups in clinical evaluations. There were two cases of re-rupture of graft at the bone-tendon junction in group I. Conclusion: We had successful results of PCL reconstruction with single-incision, single bundle technique using Achilles and tibialis anterior allograft without difference between two groups in patients with PCL injury. There were more re-rupture of graft in Achilles tendon group.

• Journal of the Korean Arthroscopy Society
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• v.16 no.1
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• pp.26-33
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• 2012

Purpose: The purpose of this study was to evaluate the clinical outcomes and stability of anatomical single bundle anterior cruciate ligament reconstruction (SBACLR) with quadriceps tendon comparable to double bundle anterior cruciate ligament reconstruction (DBACLR). Materials and Methods: We retrospectively reviewed 28 consecutive patients (16 male, 12 female) who underwent SBACLR using quadriceps tendon from March 2009 (Group 1) and compared its clinical results to whom DBACLR with semitendinosus tendon for 53 patients (51 male, 2 female) from August. 2006 (Group 2). Mean age were 34.9 (range, 16-52) in Group 1 and 21.6 (range, 17-55) in Group 2. Mean follow up periods were 13.9 months (range, 12-20) in Group 1 and 36.2 months (range, 20-52) in Group 2. Lysholm score, International Knee Documentation Committee (IKDC) evaluation form and Tegner score were performed for evaluating the clinical outcome. Lachman test, pivot shift test and KT-1000 arthrometer (MEDmetric Corp., San Diego, CA, USA) were performed for stability. Results: There was no statistical significant difference between the two groups in terms of Lysholm score (Group 1: $85.9{\pm}2.6$, Group 2: $90.9{\pm}1.0$, P=0.226), IKDC score (P=0.345) and Tegner score (Group 1: $6.9{\pm}1.4$, Group 2: $7.1{\pm}1.3$, P=0.523). Nor was there statistical significance between the two groups in terms of KT-1000 arthrometer (Group 1: $1.5{\pm}1.1\;mm$, Group 2: $1.5{\pm}1.6\;mm$, P=0.457), Lachman test (P=0.547) and pivot shift test (P=0.073). Conclusion: Anatomical SBACLR with quadriceps tendon shows similar clinical outcomes and stability comparable to anatomical DBACLR with hamstring tendon.

• Journal of the Korean Arthroscopy Society
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• v.12 no.3
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• pp.198-204
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• 2008

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.

• Journal of the Korean Arthroscopy Society
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• v.9 no.2
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• pp.222-231
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• 2005

Purpose: This article describes a double-bundle ACL reconstruction technique using a five-strand hamstring tendon autograft with conventional anteromedial bundle reconstruction and additional posterolateral bundle reconstruction. Operative technique: For the tibial tunnel, the conventional single tunnel technique is performed and for the femoral tunnel, the double tunnel technique is performed with the anteromedial and posterolateral bundle. After minimal notchplasty, the anteromedial femoral tunnel is prepared with leaving one milimeter of posterior femoral cortex within the over-the-top, which if positioned at the 11-o'clock orientation for the right knee or at the 1-o'clock position for the left knee. The posterolateral femoral tunnel that is located 5 to 7 mm superior to the inner margin of the lateral meniscus anterior horn at $90^{\circ}$ of flexion is prepared with tile outside-in technique using a 4.5 cannulated reamer. The graft material for the double bundle reconstruction is made of the conventional four-strand hamstring autograft in the anteromedial bundle and of a single-strand semitendinosus tendon in the posterolateral bundle. The anteromedial bundle is fixed with using a rigid fix system on the femoral side and the posterolateral bundle is fixed to tie with the miniplate from the outside femur. Then, with the knee in $10^{\circ}\;to\;20^{\circ}$ of flexion, a bioabsorbable screw is simultaneously applied to achieve tibial fixation with tensioning of both bundles. Conclusion: A double bundle reconstruction with five-strand hamstring autograft, which is designed with a favorable conventional anteromedial bundle and an additional posterolateral bundle to restore rotation stability, seems to be a very effective method for the treatment for ACL instabilities.