Arthroscopic single-bundle ACL reconstruction with modified double-layer bone-patellar tendon-bone allograft.

Area of Science:

• Orthopedic surgery
• Sports medicine
• Biomedical engineering

Background:

• Anterior cruciate ligament (ACL) reconstruction is a common orthopedic procedure.
• Bone-patellar tendon-bone (BPTB) autografts and allografts are widely used.
• Improving graft stability and clinical outcomes remains an area of research.

Purpose of the Study:

• To introduce a modified double-layer BPTB allograft for arthroscopic single-bundle ACL reconstruction.
• To investigate and compare the clinical outcomes of the modified double-layer allograft versus conventional single-layer BPTB allograft.

Main Methods:

• A retrospective comparative study involving 136 patients undergoing arthroscopic single-bundle ACL reconstruction.
• Patients were divided into two groups: 66 with double-layer BPTB allograft (Group 1) and 70 with conventional BPTB allograft (Group 2).
• Clinical outcomes were assessed at a minimum 2-year follow-up using Lachman tests, pivot-shift tests, KT-1000 arthrometer measurements, and Lysholm and Tegner activity scores.

Main Results:

• At a minimum 2-year follow-up, the double-layer allograft group (Group 1) showed significantly less anterior laxity (mean side-to-side difference on KT-1000: 1.2 mm vs 2.1 mm, p=0.017).
• Knee function was significantly better in Group 1, with higher Lysholm scores (94.2 vs 86.6, p=0.000) and Tegner scores (median 8 vs 6, p=0.001).

Conclusions:

• The modified double-layer BPTB allograft technique leads to significantly reduced anterior laxity in single-bundle ACL reconstruction.
• This modified allograft approach demonstrates superior knee function compared to conventional single-layer BPTB allografts.
• The study supports the use of double-layer BPTB allografts for improved outcomes in ACL reconstruction.