In vivo knee rotational stability 2 years after double-bundle and anatomic single-bundle ACL reconstruction

Eur J Trauma Emerg Surg. 2018 Feb;44(1):105-111. doi: 10.1007/s00068-017-0769-7. Epub 2017 Mar 2.

Abstract

Purpose: The objective of this study was to evaluate knee rotational stability at least 2 years after anatomic single-bundle anterior cruciate ligament (ACL) reconstruction (SB) and double-bundle ACL reconstruction (DB) in comparison with the contralateral healthy knee joint. The Cincinnati, Lysholm and IKDC scores were analysed too.

Methods: There were 40 patients in both groups, the mean follow-up was 27 months. For all measurements, the navigation system OrthoPilot was used. Measurement started with the patient in the standing position in neutral rotation. Then, the patient achieved in 30° knee flexion under weight-bearing maximal external trunk rotation and returned to the neutral position. The same measurement was done for the internal trunk rotation. For the anterior-posterior stability, KT-1000 arthrometer was used. All measurements were repeated three times for each knee joint.

Results: After the DB reconstruction, the mean external rotation of the tibia (ER) was 8.2° and the internal rotation (IR) was 10.2°. In the contralateral healthy knee joint, ER was 8.5° (p = 0.597) and IR was 12.1° (p = 0.064). After the SB reconstruction, ER was 9.4° and IR was 13.1°. In the contralateral healthy knee joint, ER was 7.7° (p = 0.066) and IR was 9.8° (p = 0.005). Anterior-posterior translation was to the same extent for both groups.

Conclusions: The DB reconstruction of the ACL restores the rotational stability of the knee joint without any significant difference in comparison to the contralateral healthy knee (p > 0.05). The main finding of this study is that the internal rotational stability of the knee joint after the anatomic SB technique is not sufficient.

Keywords: ACL; Anatomic double-bundle reconstruction; Anatomic single-bundle reconstruction; Two years rotational stability.

MeSH terms

  • Adolescent
  • Adult
  • Anterior Cruciate Ligament Injuries / physiopathology
  • Anterior Cruciate Ligament Injuries / surgery*
  • Anterior Cruciate Ligament Reconstruction*
  • Biomechanical Phenomena
  • Female
  • Follow-Up Studies
  • Humans
  • Joint Instability / physiopathology*
  • Joint Instability / surgery
  • Knee Joint / physiopathology*
  • Knee Joint / surgery
  • Male
  • Range of Motion, Articular / physiology*
  • Rotation
  • Treatment Outcome
  • Young Adult