Single-bundle patellar tendon versus non-anatomical double-bundle hamstrings ACL reconstruction: a prospective...

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomechanical Engineering

Background:

• Anterior cruciate ligament (ACL) reconstruction is a common orthopedic procedure.
• Graft choice significantly impacts patient outcomes and long-term knee health.
• Comparing different graft types and surgical techniques is crucial for optimizing ACL reconstruction protocols.

Purpose of the Study:

• To compare the long-term subjective, objective, and radiographic outcomes of single-bundle bone-patellar tendon-bone autograft versus non-anatomical double-bundle hamstring tendon autograft ACL reconstruction.
• To evaluate functional recovery, return to sport, and degenerative changes at a minimum 8-year follow-up.

Main Methods:

• Prospective evaluation of 79 patients with unilateral ACL insufficiency undergoing either technique.
• Assessment using IKDC scores, Tegner activity levels, KT-2000 arthrometer testing, and radiographic grading.
• Minimum 8.6-year follow-up, including re-intervention rates for meniscal lesions.

Main Results:

• Both techniques yielded similar subjective and objective IKDC scores.
• The double-bundle hamstring group demonstrated significantly higher Tegner levels, improved range of motion, faster sport resumption, and reduced pivot-shift phenomenon.
• The double-bundle group also showed a lower re-intervention rate and significantly fewer degenerative radiographic changes at long-term follow-up.

Conclusions:

• Double-bundle hamstring ACL reconstruction provides superior functional results compared to single-bundle patellar tendon grafts.
• This technique is associated with faster return to sport, a lower re-operation rate, and reduced long-term degenerative knee changes.
• The findings support the double-bundle hamstring technique for optimizing patient recovery and knee health after ACL reconstruction.