Comparison of Single-bundle Versus Double-bundle Anterior Cruciate Ligament Reconstruction
NCT ID: NCT06303726
Last Updated: 2024-03-12
Study Results
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Basic Information
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UNKNOWN
NA
30 participants
INTERVENTIONAL
2022-04-25
2024-06-25
Brief Summary
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The main question it aims to answer are:
* which surgery gives better outcome in patients (short- and long-term results)?
* are there any sings of osteoarthritis in an injured knee compared to a healthy knee?
Participants will be invited to our clinic after 15 years to do clinical and functional exams with x-Ray and magnetic resonance imaging (MRI) of both knees. Subjective exams with different scores (Tegner score, Lysholm score..) were also done. The same exam protocol for participant was used again after two years and fifteen years since surgery.
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Detailed Description
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The purpose of the present study was therefore to evaluate and compare the clinical results of DB hamstring and SB patellar tendon ACL reconstruction techniques.
A total of 40 patients (29 male and 11 female, average (SD) age 36) were randomized during routine surgery (2 years after the surgery) into either double bundle (DB) or single bundle (SB) group. Patients with combined (medial, lateral or posterior) ligamentous injuries were not included in the study. ACL reconstruction in DB group was done by four tunnel hamstring technique with EndoButton femoral and cancellous screw tibial fixation. In the SB group patellar tendon autograft was fixed with titanium interference screws. The same postoperative rehabilitation protocols were used for both groups.
Subjective evaluation comprised IKDC (International Knee Documentation Committee) subjective score, Tegner activity and Lysholm scores. Objective evaluation was done by the IKDC 2000 knee examination protocol. Antero - posterior stability was measured by KT 2000 (knee arthrometer) and by Rollimeter. One leg hop test was performed to assess the functional results. Isokinetic thigh muscle strength measurements on Biodex isokinetic dynamometer were performed.
The same protocol was performed for the clinical exams after 15 years since surgery. A total of 30 patients were examen. Investigators also did imaging of both knees (X-ray and MRI) for checking the sings of osteoarthritis.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
SINGLE
Study Groups
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Single bundle ACL reconstruction
In this group we chose to do surgery of ACL reconstruction with single bundle (patellar ligament).
ACL reconstruction single bundle
We will do surgery of ACL reconstruction with patellar ligament.
Double bundle ACL reconstruction
In this group we chose to do surgery of ACL reconstruction with double bundle - hamstring ligament.
ACL reconstruction double bundle
We will do surgery of ACL reconstruction with hamstring ligament.
Interventions
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ACL reconstruction single bundle
We will do surgery of ACL reconstruction with patellar ligament.
ACL reconstruction double bundle
We will do surgery of ACL reconstruction with hamstring ligament.
Eligibility Criteria
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Inclusion Criteria
* symptoms and clinical sings for rupture of ACL (instability of knee, swelling, pain, reduced knee function,...)
* patient consent
* magnetic resonance with this of kind injury
Exclusion Criteria
* major meniscus injuries
* X-ray abnormalities of injured knee
* preliminary ACL reconstruction
* associated injury to the other knee
ALL
Yes
Sponsors
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University Medical Centre Maribor
OTHER
Responsible Party
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Principal Investigators
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Mitja Kozic
Role: STUDY_CHAIR
University Clinical Center Maribor
Locations
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University Clinical Center Maribor
Maribor, , Slovenia
Countries
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References
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Freeman MA, Pinskerova V. The movement of the knee studied by magnetic resonance imaging. Clin Orthop Relat Res. 2003 May;(410):35-43. doi: 10.1097/01.blo.0000063598.67412.0d.
Browne C, Hermida JC, Bergula A, Colwell CW Jr, D'Lima DD. Patellofemoral forces after total knee arthroplasty: effect of extensor moment arm. Knee. 2005 Apr;12(2):81-8. doi: 10.1016/j.knee.2004.05.006.
Nuno N, Ahmed AM. Sagittal profile of the femoral condyles and its application to femorotibial contact analysis. J Biomech Eng. 2001 Feb;123(1):18-26. doi: 10.1115/1.1339819.
Siu D, Rudan J, Wevers HW, Griffiths P. Femoral articular shape and geometry. A three-dimensional computerized analysis of the knee. J Arthroplasty. 1996 Feb;11(2):166-73. doi: 10.1016/s0883-5403(05)80012-9.
Lonner JH, Jasko JG, Thomas BS. Anthropomorphic differences between the distal femora of men and women. Clin Orthop Relat Res. 2008 Nov;466(11):2724-9. doi: 10.1007/s11999-008-0415-0. Epub 2008 Aug 22.
Griffin FM, Insall JN, Scuderi GR. The posterior condylar angle in osteoarthritic knees. J Arthroplasty. 1998 Oct;13(7):812-5. doi: 10.1016/s0883-5403(98)90036-5.
Yoon KH, Kim JS, Kim SJ, Park M, Park SY, Park SE. Eight-year results of transtibial nonanatomic single-bundle versus double-bundle anterior cruciate ligament reconstruction: Clinical, radiologic outcomes and survivorship. J Orthop Surg (Hong Kong). 2019 May-Aug;27(2):2309499019840827. doi: 10.1177/2309499019840827.
Freedman KB, D'Amato MJ, Nedeff DD, Kaz A, Bach BR Jr. Arthroscopic anterior cruciate ligament reconstruction: a metaanalysis comparing patellar tendon and hamstring tendon autografts. Am J Sports Med. 2003 Jan-Feb;31(1):2-11. doi: 10.1177/03635465030310011501.
Adravanti P, Dini F, de Girolamo L, Cattani M, Rosa MA. Single-Bundle versus Double-Bundle Anterior Cruciate Ligament Reconstruction: A Prospective Randomized Controlled Trial with 6-Year Follow-up. J Knee Surg. 2017 Nov;30(9):898-904. doi: 10.1055/s-0037-1598176. Epub 2017 Feb 20.
Hefti F, Muller W, Jakob RP, Staubli HU. Evaluation of knee ligament injuries with the IKDC form. Knee Surg Sports Traumatol Arthrosc. 1993;1(3-4):226-34. doi: 10.1007/BF01560215.
Shaieb MD, Kan DM, Chang SK, Marumoto JM, Richardson AB. A prospective randomized comparison of patellar tendon versus semitendinosus and gracilis tendon autografts for anterior cruciate ligament reconstruction. Am J Sports Med. 2002 Mar-Apr;30(2):214-20. doi: 10.1177/03635465020300021201.
Jarvela S, Kiekara T, Suomalainen P, Jarvela T. Double-Bundle Versus Single-Bundle Anterior Cruciate Ligament Reconstruction: A Prospective Randomized Study With 10-Year Results. Am J Sports Med. 2017 Sep;45(11):2578-2585. doi: 10.1177/0363546517712231. Epub 2017 Jun 29.
Briggs KK, Steadman JR, Hay CJ, Hines SL. Lysholm score and Tegner activity level in individuals with normal knees. Am J Sports Med. 2009 May;37(5):898-901. doi: 10.1177/0363546508330149. Epub 2009 Mar 23.
Marmura H, Getgood AMJ, Spindler KP, Kattan MW, Briskin I, Bryant DM. Validation of a Risk Calculator to Personalize Graft Choice and Reduce Rupture Rates for Anterior Cruciate Ligament Reconstruction. Am J Sports Med. 2021 Jun;49(7):1777-1785. doi: 10.1177/03635465211010798. Epub 2021 May 4.
Other Identifiers
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IRP-2021/02-19
Identifier Type: -
Identifier Source: org_study_id
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