Kinematic study following double-bundle, anterior cruciate ligament reconstruction

The purpose of this study was to evaluate tibiofemoral kinematics after double-bundle anterior cruciate ligament (ACL) reconstructions and compare them with those of successful single-bundle reconstructions and contralateral normal knees using open MR images. We obtained MR images based on the flexion angle without weight-bearing, from 20 patients with successful unilateral single-bundle (10 patients) and double-bundle (10 patients) ACL reconstructions with tibialis anterior allografts and a minimum 1-year follow-up. The MR images of the contralateral uninjured knees were used as normal controls. Sagittal images of the mid-medial and mid-lateral sections of the tibiofemoral compartments were used to measure the translation of the femoral condyles relative to the tibia. The mean translations of the medial femoral condyles on the tibial plateaus during knee joint motion showed no significant differences among normal, single-bundle, and double-bundle ACL reconstructed knees (all p>0.05). The mean translations of the lateral femoral condyles showed a significant difference between normal and single-bundle reconstructed knees, or between single-bundle and double-bundle reconstructed knees (p<0.05). However, there was no significant difference between normal and double-bundle reconstructed knees (p=0.220). These findings suggest that double-bundle ACL reconstruction restores normal kinematic tibiofemoral motion better than single-bundle reconstruction.