2023 ISAKOS Biennial Congress ePoster
Short-Term Clinical Outcomes of Remnant-Preserving Single-Bundle Augmentation in Anterior Cruciate Ligament Reconstruction: Comparison with Single- and Double-Bundle Reconstruction
Mariko Osugi, MD, Hiroshima JAPAN
Atsuo Nakamae, MD, PhD, Hiroshima JAPAN
Kazuhiro Tsukisaka, MD, , Aki-Gun, Hiroshima JAPAN
Masataka Deie, MD, PhD, Prof., Hiroshima, hiroshima JAPAN
Nobuo Adachi, MD, PhD, Hiroshima JAPAN
Hiroshima University , Hiroshima, Hiroshima, JAPAN
FDA Status Cleared
Summary
Patients in the ACL augmentation group showed better pivot shift test results than those in the single-bundle reconstruction group at one year after surgery.
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Abstract
Objectives:
This study aimed to evaluate the clinical outcomes of single-bundle anterior cruciate ligament (ACL) augmentation (remnant preserving ACL reconstruction) and to compare them with those of anatomic single- or double-bundle ACL reconstruction.
Methods
This multicenter study included patients with ACL injury at 9 institutions. A total of 565 patients who underwent ACL reconstruction or augmentation and followed up for one year after surgery were enrolled. There were 206 single-bundle ACL augmentations (104 female, 102 male), 121 double-bundle ACL reconstructions (47 female, 74 male), and 238 single-bundle ACL reconstructions (127 female, 111 male). Patients were assessed preoperatively and postoperatively with the Knee Injury and Osteoarthritis Outcome Score (KOOS), measurement of anterior knee laxity using an arthrometer, the pivot-shift test, and the range of motion of the knee.
Results
The mean side-to-side differences measured with an arthrometer at one year after surgery were 0.5 mm in the remnant-preserving augmentation group, 0.9 mm in the single-bundle reconstruction group and 0.7 mm in the double-bundle reconstruction group; the result did not differ significantly among the groups (P=0.34). Postoperative pivot shift test grade was significantly lower in ACL augmentation group than single-bundle reconstruction group (P=0.003). There were no significant differences in the postoperative KOOS subscales among the three groups. Although extension disturbance of the knee after ACL surgery was significantly worse in double-bundle reconstruction group, the difference had already been found before the surgery.
Conclusions
Patients in the ACL augmentation group showed better pivot shift test results than those in the single-bundle reconstruction group at one year after surgery. Clinical outcomes of the patients with ACL augmentation were comparable, if not superior, with those of patients undergoing the double-bundle ACL reconstruction.