Vol. 5, Issue 4 (2019)

A 5 year prospective double blind comparative study of ACL reconstruction using hamstring single bundle vs double bundle graft

Author(s):

Madhava Reddy I, Mohan Babu, Venu Gopal, Deepak, C Sahu and Vidya Sagar JVS

Abstract:
Introduction: Over the last few decades injuries of the knee joint have played a major role, due to many popular knee pivoting sports including soccer, skiing and basketball.
Ligament injury accounts for nearly 40% of all knee injury problems and isolated anterior cruciate ligament injury constitutes nearly 50% of all knee ligament injuries. Approximately 3,00,000 anterior cruciate ligament reconstructions are performed in the USA alone each year. Better understanding of injury mechanisms lead to prevention strategies against anterior cruciate ligament injury with some effectiveness although, anterior cruciate ligament injury is still not fully preventable.
Anterior cruciate ligament was considered of little importance for the long term function of the knee in the past. Studies have shown that there is greater risk of meniscal and articular injuries in short term progressing to radiological and clinical changes of joint degeneration in the long term in anterior cruciate ligament deficient patients compared to subjects with normal anterior cruciate ligament function.
Non operative management has not been proven to prevent or delay long term sequelae of anterior cruciate ligament deficiency. Early surgical methods such as primary repair of anterior cruciate ligament injury with or without augmentation showed a modest to poor improvement over non-operative management in terms of subjective and functional outcome of symptomatic knee instability.
Reconstruction of ACL is best way of management with failure rate of around 10 %. Varieties of graft materials available for surgeons’ choice are auto grafts, allograft and synthetic graft materials. Success rates of ligament reconstruction using auto grafts are higher than when either allograft or synthetic graft materials were used. Anterior cruciate ligament reconstruction is done either by single bundle or double bundle reconstruction. Double bundle reconstruction is increasingly common. However, no definitive data on the superiority of double bundle technique have been shown when compared with single bundle reconstruction.
In the present study we have tried to compare outcome of single bundle and double bundle Anterior cruciate ligament Reconstructions using semitendinosus tendon tripled with ipsilateral and contralateral Semitendinosus tendons for double bundle technique and only ipsilateral Semitendinosus tendon for single bundle technique with tunnel mouth fixation of graft using smooth threaded interference screws (UNILINK, Mumbai) in all the cases in both groups.
Aim of the study: To objectively evaluate short term functional results of single bundle (non-isometric) and double bundle (single tibial tunnel with two femoral tunnels – 11 0’ clock & 9.30 or 1 0’ clock & 2.30 positions) arthroscopic anterior cruciate ligament reconstruction using semitendinosus tendon (autologous) and tunnel mouth fixation.
Conclusion: we conclude No clear cut advantage for either Single bundle technique or Double bundle technique of anterior cruciate ligament reconstruction in terms of post-operative outcomes or complications.

Pages: 683-688  |  904 Views  222 Downloads

How to cite this article:
Madhava Reddy I, Mohan Babu, Venu Gopal, Deepak, C Sahu and Vidya Sagar JVS. A 5 year prospective double blind comparative study of ACL reconstruction using hamstring single bundle vs double bundle graft. Int. J. Orthop. Sci. 2019;5(4):683-688. DOI: 10.22271/ortho.2019.v5.i4l.1754