Document Detail


Anatomic double-bundle anterior cruciate ligament reconstruction using hamstring tendons with minimally required initial tension.
MedLine Citation:
PMID:  20887927     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Our purpose was to clarify the clinical outcomes at 2 years after anatomic double-bundle anterior cruciate ligament (ACL) reconstruction with 20 N of the initial tension, which was the minimally required initial tension to perform the reconstruction successfully according to our previous report about the pre-tension necessary to restore the laxity found in the opposite knee (7.3 N; range, 2.2 to 14 N).
METHODS: Of 64 patients who underwent anatomic double-bundle ACL reconstruction with autogenous semitendinosus tendon, 45 were periodically examined for 2 years. Two double-looped grafts were fixed with EndoButton CL devices (Smith & Nephew Endoscopy, Andover, MA) on the femoral side and Double Spike Plates (Smith & Nephew Endoscopy) on the tibial side, while a total of 20 N of initial tension (10 N to each graft) was applied at 20° of knee flexion. The International Knee Documentation Committee Knee Examination Form and Lysholm score were used for the subjective assessment, whereas range of motion and knee stability were evaluated as the objective assessment. Grafts were evaluated in 25 patients with second-look arthroscopy.
RESULTS: According to the International Knee Documentation Committee subjective assessment, 62% of knees were graded as normal and 38% as nearly normal. The Lysholm score was 72 points in the preoperative period and improved to 99 points at 2 years' follow-up. A loss of knee extension of less than 3° was found in 2 patients. The pivot-shift test was evaluated as negative in all patients except for 5 as a glide. KT-2000 knee arthrometer side-to-side difference (MEDmetric, San Diego, CA) was 0.1 ± 0.9 mm at 2 years' follow-up. Of the subset of grafts evaluated by second-look arthroscopy, most were considered to have good synovial coverage and to be taut.
CONCLUSIONS: The anatomic double-bundle ACL reconstruction with 20 N of low initial tension yielded good clinical outcomes at 2 years postoperatively, and second-look arthroscopic findings were excellent.
LEVEL OF EVIDENCE: Level IV, therapeutic case series.
Authors:
Tatsuo Mae; Konsei Shino; Norinao Matsumoto; Takashi Natsu-Ume; Kenji Yoneda; Hideki Yoshikawa; Minoru Yoneda
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association     Volume:  26     ISSN:  1526-3231     ISO Abbreviation:  Arthroscopy     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-04     Completed Date:  2011-02-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8506498     Medline TA:  Arthroscopy     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1289-95     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Sports Medicine, Osaka Kousei-Nenkin Hospital, Osaka, Japan. ta-mae@unim.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anterior Cruciate Ligament / anatomy & histology,  surgery*
Arthroscopy / methods
Female
Functional Laterality
Humans
Knee Joint / pathology,  surgery
Male
Middle Aged
Osteoarthritis, Knee / surgery
Range of Motion, Articular
Reconstructive Surgical Procedures / methods*
Running
Second-Look Surgery / methods
Stress, Mechanical
Tendons / surgery*,  transplantation*
Treatment Outcome
Weight-Bearing

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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