Short-Term Study of the Outcome of a New Instrument for All-Inside Double-Bundle Anterior Cruciate Ligament Reconstruction

• Published in: Arthroscopy Vol. 31; no. 10; pp. 1893 - 1902
• Main Authors: Watanabe, Seiji, M.D, Takahashi, Toshiaki, M.D., Ph.D, Hino, Kazunori, M.D., Ph.D, Kutsuna, Tatsuhiko, M.D., Ph.D, Ohnishi, Yoshio, M.D, Ishimaru, Masami, M.D., Ph.D, Miura, Hiromasa, M.D., Ph.D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2015
• Subjects: Adult; Anterior Cruciate Ligament - surgery; Anterior Cruciate Ligament Reconstruction - methods; Female; Femur - surgery; Humans; Imaging, Three-Dimensional; Joint Instability - surgery; Knee Joint - surgery; Male; Middle Aged; Orthopedics; Osteotomy - methods; Tibia - surgery; Time Factors; Tomography, X-Ray Computed; Young Adult
• ISSN: 0749-8063; 1526-3231
• DOI: 10.1016/j.arthro.2015.03.027

Purpose The purpose of this study was to evaluate the short-term clinical results and location of the bone tunnel with a new surgical procedure for all-inside double-bundle anterior cruciate ligament (ACL) reconstruction. Methods The double-bundle ACL reconstruction procedure was performed in 24 patients (13 male and 11 female patients) with a mean age of 31.0 years. Anterior and posterior tibial translation using an arthrometer (KT-1000; MEDmetric, San Diego, CA) and the Lysholm score were measured before surgery and at a mean of 24.8 months (range, 13 to 45 months) postoperatively. Computed tomography scans were taken to evaluate the bone tunnel positions using 3-dimensional images with the quadrant method for the femoral tunnel and Stäubli's technique for the tibial tunnel. Results Three-dimensional computed tomography scans showed that the anteromedial and posterolateral tunnels were placed in anatomically appropriate positions. Arthrometric measurements showed that the mean side-to-side differences were 5.3 mm (SD, 1.6 mm) preoperatively and 0.05 mm (SD, 0.7 mm) at a mean of 24.8 months postoperatively, indicating a remarkable improvement ( P < .00001). The mean Lysholm score was 56.3 points (SD, 14.8 points) preoperatively and 95.5 points (SD, 3.8 points) at final follow-up and was significantly improved after the operation ( P < .00001). Conclusions The all-inside double-bundle ACL reconstruction technique used in this study resulted in the creation of tunnels in an anatomically appropriate position. Short-term clinical follow-up showed improvement in patient-reported outcomes and knee stability. This technique may provide an alternative option for all-inside ACL reconstruction. Level of Evidence Level IV, therapeutic case series.