Two-bundle, four-tunnel anterior cruciate ligament reconstruction

Knee Surg Sports Traumatol Arthrosc. 2006 Jul;14(7):629-36. doi: 10.1007/s00167-005-0002-9. Epub 2005 Dec 9.


We reviewed 33 patients who underwent anterior cruciate ligament (ACL) reconstruction using a two-bundle, four-tunnel technique. The posterolateral bundle (PLB) and anteromedial bundle (AMB) were individually reconstructed with gracilis and semitendinosus tendon auto-grafts, respectively, using separate tibial and femoral tunnels. At final follow-up (24 months post surgery, range 18-31) the International Knee Documentation Committee's (IKDC) objective final evaluation scores were 69 A, 19 B, 12% C. The mean global subjective IKDC score was 86+/-12 points. Ninety-four percent of the patients had returned to sport after an average of 9 months following surgery and 75% returned to their preinjury sporting level. One patient had suffered a graft rupture as a result of a further sports injury. Eighty-four percent of the patients had a negative pivot shift (IKDC A), 9% a glide (IKDC B), and 6% a "clunk" (IKDC C). The mean postoperative side-to-side laxity, measured with KT1000 arthrometry at manual maximum, was 0.9 mm (SD 1.9). Eighty-one percent of the patients had less than 3 mm difference, with only one patient having greater than 5 mm. Our early experience with this new technique appears to demonstrate satisfactory results that are at least equivalent to other techniques and show an apparent trend towards improved control of anterior laxity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anterior Cruciate Ligament / physiopathology
  • Anterior Cruciate Ligament / surgery*
  • Anterior Cruciate Ligament Injuries
  • Arthrometry, Articular
  • Female
  • Femur / surgery*
  • Follow-Up Studies
  • Humans
  • Joint Instability / diagnostic imaging
  • Joint Instability / physiopathology
  • Knee Joint / diagnostic imaging
  • Knee Joint / physiopathology
  • Knee Joint / surgery
  • Male
  • Orthopedic Procedures / methods*
  • Radiography
  • Range of Motion, Articular / physiology
  • Recovery of Function / physiology
  • Tendons / transplantation*
  • Tibia / surgery*
  • Transplantation, Autologous
  • Treatment Outcome