Single-bundle modified patellar tendon versus double-bundle tibialis anterior allograft ACL reconstruction: a...

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomaterials in Reconstruction

Background:

• Anterior cruciate ligament (ACL) tears are common knee injuries.
• Graft choice significantly impacts ACL reconstruction outcomes.
• Comparing single-bundle (SB) and double-bundle (DB) techniques with different allografts is crucial for optimizing patient results.

Purpose of the Study:

• To prospectively compare clinical outcomes of SB ACL reconstruction with modified bone-patellar tendon-bone (BPTB) allograft versus DB ACL reconstruction with tibialis anterior allograft.
• To evaluate knee stability and function at a minimum 2-year follow-up.

Main Methods:

• A prospective study involving 94 patients undergoing ACL reconstruction.
• Group S: 43 patients with SB ACL reconstruction using modified BPTB allograft.
• Group D: 41 patients with DB ACL reconstruction using tibialis anterior allograft. Clinical assessments included Lachman, pivot-shift tests, KT-1000 measurements, IKDC, Lysholm, and Tegner scores.

Main Results:

• Graft sizes differed significantly between groups (SB: 9.9 mm; DB anteromedial: 7.5 mm; DB posterolateral: 6.6 mm; p < 0.001).
• No statistical differences were observed in Lachman tests, pivot-shift tests, or side-to-side differences between the SB and DB groups at follow-up.
• Both groups demonstrated substantial improvements in subjective knee function scores without significant intergroup differences.

Conclusions:

• SB ACL reconstruction with modified BPTB allograft yields similar knee stability (anterior-posterior and rotational) and function compared to DB reconstruction with tibialis anterior allograft after a 2-year minimum follow-up.
• Modified BPTB allograft is a recommended graft option for SB ACL reconstruction.
• Both surgical techniques provide comparable clinical outcomes for ACL reconstruction.