Arthroscopic single-bundle ACL reconstruction with modified double-layer bone-patellar tendon-bone allograft

Knee Surg Sports Traumatol Arthrosc. 2013 Sep;21(9):2066-71. doi: 10.1007/s00167-012-2235-8. Epub 2012 Oct 4.

Abstract

Purpose: The objective of present study was to introduce a modified double-layer bone-patellar tendon-bone (BPTB) allograft for arthroscopic single-bundle ACL reconstruction and investigate the clinical outcomes.

Methods: From 2007 to 2009, a total of 136 patients underwent arthroscopic single-bundle ACL reconstructions with BPTB allograft. Of which, 66 patients were with double-layer BPTB allograft (Group 1), and 70 patients were with conventional BPTB allograft (Group 2). Clinical outcomes including Lachman and pivot-shift tests, KT-1000 arthrometer measurements, and Lysholm and Tegner activity scores were compared between the two groups at a 2-year minimum follow-up.

Results: Forty-six patients in each group were at a two-year minimum follow-up. The mean side-to-side difference on the KT-1000 arthrometer was 1.2 ± 1.2 mm for group 1 and 2.1 ± 1.9 mm for group 2, with significant difference between the two groups (p = 0.017). The knee function was significantly better for group 1 than for group 2, because the mean Lysholm score was 94.2 ± 4.8 points versus 86.6 ± 7.1 points (p = 0.000), and the median Tegner score was 8 (range 5-10) points versus 6 (range 4-10) points (p = 0.001).

Conclusions: On the basis of the KT-1000 arthrometer evaluation and clinical measures, single-bundle ACL reconstruction with double-layer BPTB allograft achieves significantly lesser anterior laxity and better knee function than a single-layer allograft reconstruction.

Level of evidence: Therapeutic, retrospective comparative study, Level III.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Allografts
  • Anterior Cruciate Ligament / surgery
  • Anterior Cruciate Ligament Injuries*
  • Anterior Cruciate Ligament Reconstruction / methods*
  • Arthroscopy
  • Bone-Patellar Tendon-Bone Grafting / methods*
  • Bone-Patellar Tendon-Bone Grafts
  • Female
  • Humans
  • Joint Instability / prevention & control
  • Male
  • Retrospective Studies
  • Young Adult