Background:

Biomechanical studies have shown excellent anteroposterior and rotatory laxity control after double-bundle (DB) anterior cruciate ligament (ACL) reconstruction, but no clinical studies have compared midterm (>5-year) residual laxity between the DB and single-bundle (SB) techniques.

Purpose:

To clinically compare sagittal and rotatory laxities and residual sagittal laxity on the KT-1000 arthrometer between patients treated with an SB ACL reconstruction and those treated with a DB ACL reconstruction at the 7-year follow-up.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A total of 110 patients were included between January 2006 and December 2007. The patients were randomly assigned into 2 groups: those treated with SB ACL reconstruction (n = 63) and those treated with the DB technique (n = 47). All patients were then reviewed at a minimum of 7 years of follow-up; patients with ACL rerupture (n = 3 in the SB group and n = 2 in the DB group) were excluded from the postoperative comparative analysis. Residual anterior laxity (Lachman test), rotatory laxity (pivot-shift test), and sagittal laxity (KT-1000 arthrometer side-to-side difference) were measured and compared between the 2 groups.

Results:

The mean age at surgery was 23.0 ± 5.1 years for the DB group and 28.1 ± 7.0 years for the SB group, and the mean follow-up was 7.4 ± 0.8 years. No statistically significant differences were found between the 2 groups in terms of age, sex, preoperative laxity on KT-1000, preoperative Tegner score, or concomitant meniscal lesions. Residual postoperative laxity via Lachman testing (P < .01), pivot-shift testing (P = .042), and the KT-1000 arthrometer (P < .01) was statistically significantly in favor of DB reconstruction.

Conclusion:

DB ACL reconstruction allowed better control of anterior stability during the evaluation via the Lachman test and via objective measurement on the KT-1000, as well as rotatory stability at a minimum of 7 years of follow-up.

中文翻译：

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单束与双束 ACL 重建后旋转和矢状松弛的比较：7 年随访结果

背景：

生物力学研究表明双束 (DB) 前交叉韧带 (ACL) 重建后的前后和旋转松弛控制良好，但没有临床研究比较 DB 和单束 (SB) 之间的中期（> 5 年）残余松弛技巧。

目的：

临床比较接受 SB ACL 重建治疗的患者与接受 DB ACL 重建治疗的患者在 7 年随访时的 KT-1000 关节计上的矢状面和旋转松弛度以及残余矢状面松弛度。

学习规划：

队列研究；证据水平，3。

方法：

2006 年 1 月至 2007 年 12 月期间共纳入 110 名患者。患者被随机分为 2 组：接受 SB ACL 重建的患者 (n = 63) 和接受 DB 技术治疗的患者 (n = 47)。然后在至少 7 年的随访中对所有患者进行复查；ACL 再破裂患者（SB 组 n = 3，DB 组 n = 2）被排除在术后比较分析之外。测量并比较两组的残余前部松弛（Lachman 测试）、旋转松弛（枢轴移位测试）和矢状松弛（KT-1000 关节计左右差异）。

结果：

DB组的平均手术年龄为23.0±5.1岁，SB组为28.1±7.0岁，平均随访时间为7.4±0.8岁。两组在年龄、性别、KT-1000 上的术前松弛度、术前 Tegner 评分或伴随的半月板损伤方面均无统计学差异。通过 Lachman 测试 ( P < .01)、枢轴移位测试 ( P = .042) 和 KT-1000 关节计 ( P < .01) 发现的术后残余松弛在统计学上显着有利于 DB 重建。

结论：

DB ACL 重建通过 Lachman 测试和 KT-1000 上的客观测量在评估期间可以更好地控制前部稳定性，以及至少 7 年随访的旋转稳定性。