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Single-Tunnel Double-Bundle-Like Effect With Footprint Enhancing Anterior Cruciate Ligament Reconstruction

Overview
Journal Arthrosc Tech
Publisher Elsevier
Date 2022 Mar 8
PMID 35256968
Authors
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Abstract

The anterior cruciate ligament (ACL) consists of an anteromedial bundle and a posterolateral bundle giving anteroposterior and rotational stability. It's one of the most commonly injured ligaments and also one of the most commonly performed arthroscopic procedures. Management of ACL injuries is one of the most frequently studied subjects in the literature. Surgical management of ACL injuries varies from extraarticular tenodesis to arthroscopic transtibial reconstruction to double-bundle reconstruction to anatomic single-bundle reconstruction. Although double-bundle ACL reconstruction gives more rotational stability than anatomic single-bundle, functional outcome of both are the same, but the complication rates are much higher for double-bundle reconstruction. Hence, anatomic single-bundle ACL reconstruction has gained popularity. The femoral and tibial footprint of the ACL varies in shape and size; it can be oval, elliptical, rectangular, C-shape, and more. But all available ACL reconstruction techniques prepare a circular tunnel; hence, the footprint coverage of the native ACL is maximum after double-bundle reconstruction and less after anatomic single-bundle reconstruction. So, to have the benefit of double-bundle reconstruction with a single tunnel, we propose our technique of a single-tunnel double-bundle-like effect, with the footprint enhancing ACL reconstruction using our newly designed tunnel dilators.

References
1.
Petersen W, Forkel P, Achtnich A, Metzlaff S, Zantop T . Technique of anatomical footprint reconstruction of the ACL with oval tunnels and medial portal aimers. Arch Orthop Trauma Surg. 2013; 133(6):827-33. DOI: 10.1007/s00402-013-1741-6. View

2.
Nordenvall R, Bahmanyar S, Adami J, Stenros C, Wredmark T, Fellander-Tsai L . A population-based nationwide study of cruciate ligament injury in Sweden, 2001-2009: incidence, treatment, and sex differences. Am J Sports Med. 2012; 40(8):1808-13. DOI: 10.1177/0363546512449306. View

3.
Zhao F, Hu X, Zhang J, Shi W, Ren B, Huang H . A more flattened bone tunnel has a positive effect on tendon-bone healing in the early period after ACL reconstruction. Knee Surg Sports Traumatol Arthrosc. 2019; 27(11):3543-3551. DOI: 10.1007/s00167-019-05420-7. View

4.
Nakase J, Takata Y, Shimozaki K, Asai K, Yoshimizu R, Kimura M . Clinical study of anatomical ACL reconstruction using a rounded rectangular dilator. BMC Musculoskelet Disord. 2021; 22(1):38. PMC: 7791683. DOI: 10.1186/s12891-020-03913-y. View

5.
Yasuda K, Kondo E, Ichiyama H, Tanabe Y, Tohyama H . Clinical evaluation of anatomic double-bundle anterior cruciate ligament reconstruction procedure using hamstring tendon grafts: comparisons among 3 different procedures. Arthroscopy. 2006; 22(3):240-51. DOI: 10.1016/j.arthro.2005.12.017. View