Current Concepts Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction

Anterior cruciate ligament (ACL) reconstruction is one of the most common procedures performed by orthopaedic surgeons. The procedure has improved significantly since its inception in 1900 and continues to be intensively studied with outcomes receiving considerable attention. Traditional ACL reconstruction techniques have focused on one portion of the ACL—the antero- medial bundle. Single-bundle ACL reconstruction is the criterion standard and has provided good to excellent results, with many athletes being able to return to sports; however, recently, some authors have noted persistent instability with functional testing and degenerative radiographic changes after single-bundle ACL reconstruction. As a result, several centers have attempted to improve upon the single-bundle technique by reconstructing both the anteromedial and posterolateral bundles of the ACL. This article will present the embryologic, anatomic, and biomechanical rationale for double- bundle ACL reconstruction. In addition, the latest outcomes of double-bundle ACL reconstruction will be presented. Key Words: Anterior cruciate ligament—Double bundle—Anatomic reconstruc- tion—Rotational stability—Clinical outcome.

[1]  K. Shino,et al.  Single- versus bi-socket anterior cruciate ligament reconstruction using autogenous multiple-stranded hamstring tendons with endoButton femoral fixation: A prospective study. , 2001, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[2]  R O'RAHILLY,et al.  The early prenatal development of the human knee joint. , 1951, Journal of anatomy.

[3]  B. Zaricznyj.  Reconstruction of the Anterior Cruciate Ligament of the Knee Using a Doubled Tendon Graft , 1987, Clinical orthopaedics and related research.

[4]  Freddie H. Fu,et al.  Determination of the in situ loads on the human anterior cruciate ligament , 1993, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[5]  H. Tohyama,et al.  Clinical evaluation of anatomic double-bundle anterior cruciate ligament reconstruction procedure using hamstring tendon grafts: comparisons among 3 different procedures. , 2006, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[6]  Leo A. Pinczewski,et al.  A 7-Year Follow-up of Patellar Tendon and Hamstring Tendon Grafts for Arthroscopic Anterior Cruciate Ligament Reconstruction , 2005, The American journal of sports medicine.

[7]  D. Fithian,et al.  Fate of the anterior cruciate ligament-injured knee. , 2002, The Orthopedic clinics of North America.

[8]  Yuji Yamamoto,et al.  Knee Stability and Graft Function after Anterior Cruciate Ligament Reconstruction , 2004, The American journal of sports medicine.

[9]  Masaaki Takahashi,et al.  Anatomical Study of the Femoral and Tibial Insertions of the Anteromedial and Posterolateral Bundles of Human Anterior Cruciate Ligament , 2006, The American journal of sports medicine.

[10]  J. Kennedy,et al.  The anatomy and function of the anterior cruciate ligament. As determined by clinical and morphological studies. , 1974, The Journal of bone and joint surgery. American volume.

[11]  S. Woo,et al.  Quantitative analysis of human cruciate ligament insertions. , 1999, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[12]  F. Girgis,et al.  The cruciate ligaments of the knee joint. Anatomical, functional and experimental analysis. , 1975, Clinical orthopaedics and related research.

[13]  E. Gardner,et al.  The early development of the knee joint in staged human embryos. , 1968, Journal of anatomy.

[14]  Mary T. Gabriel,et al.  Distribution of in situ forces in the anterior cruciate ligament in response to rotatory loads , 2004, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[15]  William I. Sterett,et al.  Relationships between Objective Assessment of Ligament Stability and Subjective Assessment of Symptoms and Function after Anterior Cruciate Ligament Reconstruction , 2004, The American journal of sports medicine.

[16]  D. Diduch,et al.  The effect of pretwisting the ACL autograft on knee laxity. , 1998, The American journal of knee surgery.

[17]  N. Adachi,et al.  Reconstruction of the anterior cruciate ligament. Single- versus double-bundle multistranded hamstring tendons. , 2004, The Journal of bone and joint surgery. British volume.

[18]  T. Rosenberg,et al.  Quadrupled semitendinosus anterior cruciate ligament reconstruction: 5-year results in patients without meniscus loss. , 2001, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[19]  Freddie H. Fu,et al.  Biomechanical Analysis of an Anatomic Anterior Cruciate Ligament Reconstruction , 2002, The American journal of sports medicine.

[20]  Dale M. Daniel,et al.  Prospective Trial of a Treatment Algorithm for the Management of the Anterior Cruciate Ligament-Injured Knee , 2005, The American journal of sports medicine.

[21]  J. Kartus,et al.  Patellar Tendon or Semitendinosus Tendon Autografts for Anterior Cruciate Ligament Reconstruction , 2007, The American journal of sports medicine.

[22]  B. Bach,et al.  Arthroscopic Anterior Cruciate Ligament Reconstruction: A Metaanalysis Comparing Patellar Tendon and Hamstring Tendon Autografts , 2003, The American journal of sports medicine.

[23]  Hideyuki Koga,et al.  A retrospective study of the midterm outcome of two-bundle anterior cruciate ligament reconstruction using quadrupled semitendinosus tendon in comparison with one-bundle reconstruction. , 2006, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[24]  T. Hewett,et al.  Noncontact anterior cruciate ligament injuries: risk factors and prevention strategies. , 2000, The Journal of the American Academy of Orthopaedic Surgeons.

[25]  Scott Tashman,et al.  Abnormal Rotational Knee Motion during Running after Anterior Cruciate Ligament Reconstruction , 2004, The American journal of sports medicine.

[26]  I. Sekiya,et al.  Two-bundle reconstruction of the anterior cruciate ligament using semitendinosus tendon with endobuttons: operative technique and preliminary results. , 1999, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[27]  Richard J Hawkins,et al.  Orthopaedic Care of the Aging Athlete , 2005, The Journal of the American Academy of Orthopaedic Surgeons.

[28]  Lennart Magnusson,et al.  Outcome and risk factors after anterior cruciate ligament reconstruction: a follow-up study of 948 patients. , 2005, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[29]  A. A. Amis,et al.  Anterior cruciate ligament graft positioning, tensioning and twisting , 1998, Knee Surgery, Sports Traumatology, Arthroscopy.

[30]  W. Petersen,et al.  [Anatomy and function of the anterior cruciate ligament]. , 2002, Der Orthopade.

[31]  H. Potter,et al.  The Relationship of the Femoral Origin of the Anterior Cruciate Ligament and the Distal Femoral Physeal Plate in the Skeletally Immature Knee , 2001, The American journal of sports medicine.

[32]  R. Galeazzi,et al.  CLINICAL AND EXPERIMENTAL STUDY OF LESIONS OF THE SEMILUNAR CARTILAGES OF THE KNEE JOINT , 1927 .

[33]  Eiji Kondo,et al.  Anatomic reconstruction of the anteromedial and posterolateral bundles of the anterior cruciate ligament using hamstring tendon grafts. , 2004, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[34]  Freddie H. Fu,et al.  In situ forces in the anterior cruciate ligament and its bundles in response to anterior tibial loads , 1997, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[35]  Christopher D Harner,et al.  Double bundle or double trouble? , 2004, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[36]  A. Amis,et al.  Functional anatomy of the anterior cruciate ligament. Fibre bundle actions related to ligament replacements and injuries. , 1991, The Journal of bone and joint surgery. British volume.

[37]  T. Andriacchi,et al.  Interactions between kinematics and loading during walking for the normal and ACL deficient knee. , 2005, Journal of biomechanics.

[38]  Tomoyuki Mochizuki,et al.  Cadaveric knee observation study for describing anatomic femoral tunnel placement for two-bundle anterior cruciate ligament reconstruction. , 2006, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[39]  M. Järvinen,et al.  The Incidence of Patellofemoral Osteoarthritis and Associated Findings 7 Years after Anterior Cruciate Ligament Reconstruction with a Bone-Patellar Tendon-Bone Autograft , 2001, The American journal of sports medicine.

[40]  N. Stergiou,et al.  The effects of anterior cruciate ligament reconstruction on tibial rotation during pivoting after descending stairs , 2003, Knee Surgery, Sports Traumatology, Arthroscopy.

[41]  Shinichi Yoshiya,et al.  A Comparison of Bone-Patellar Tendon-Bone and Bone-Hamstring Tendon-Bone Autografts for Anterior Cruciate Ligament Reconstruction , 2006, The American journal of sports medicine.

[42]  S. Howell,et al.  Principles for placing the tibial tunnel and avoiding roof impingement during reconstruction of a torn anterior cruciate ligament , 1998, Knee Surgery, Sports Traumatology, Arthroscopy.

[43]  H P Stern,et al.  Young Children in Recreational Sports , 1990, Clinical pediatrics.

[44]  H. Jonsson,et al.  Positive pivot shift after ACL reconstruction predicts later osteoarthrosis63 patients followed 5–9 years after surgery , 2004, Acta orthopaedica Scandinavica.

[45]  H. Yoshikawa,et al.  Single- versus two-femoral socket anterior cruciate ligament reconstruction technique: Biomechanical analysis using a robotic simulator. , 2001, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[46]  S. Arnoczky,et al.  Anatomy of the anterior cruciate ligament. , 1983, Clinical orthopaedics and related research.

[47]  Charles H. Brown,et al.  Anterior cruciate ligament graft fixation. , 2002, The Orthopedic clinics of North America.

[48]  N. Stergiou,et al.  Excessive tibial rotation during high-demand activities is not restored by anterior cruciate ligament reconstruction. , 2005, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[49]  J. Gillquist,et al.  Functional anatomy of the anterior cruciate ligament and a rationale for reconstruction. , 1985, The Journal of bone and joint surgery. American volume.

[50]  M. Naughton,et al.  Analysis of outcomes of anterior cruciate ligament repair with 5-year follow-up: allograft versus autograft. , 2003, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[51]  Ellison Ae,et al.  Embryology, anatomy, and function of the anterior cruciate ligament. , 1985 .