Anatomic Single-bundle Anterior Cruciate Ligament Reconstruction in Asian Population

Background: Non-anatomic tunnel placement, which leads to failure in double-bundle anterior cruciate ligament (ACL), has focused greater attention on single-bundle ACL reconstruction. However, single-bundle ACL with 2- to 4-strand autogenous hamstring tendon graft always showed weak graft strength.

Methods: To solve this problem, single-bundle ACL with 6-strand autogenous hamstring tendon graft was performed on 32 Asian patients in this study. At 24 months post-operatively, all patients were evaluated with Lysholm knee scores, Tegner activity level and KT-1000 examinations.

Results: The results demonstrated that no patients showed knee extension limitation. Of the 32 patients, there were 26 negative and 6 positive 1° in Lachman test; 31 negative and 1 positive 1° in pivot-shift test. There were four patients with a 5° flexion limitation. The median Lysholm score increased from 45 preoperatively to 92 post-operatively (P < 0.001). The median Tegner sport level score increased from 1 preoperatively to 4 post-operatively (P < 0.001). KT-1000 examination revealed that the median anterior laxity at 25° of flexion was 6.3 mm preoperatively and 1.7 mm post-operatively (P < 0.001).

Conclusions: The data showed that arthroscopic central anatomic single-bundle ACL reconstruction with 6-strand autogenous hamstring tendon graft is a reliable method to restore stabilization and function of the knee.