Related Experiment Video
Updated: Sep 27, 2025
Harvesting of Peroneus Longus Tendon Autograft
Published on: September 2, 2025
Equivalent outcomes of ACL revision with over-the-top single and double-bundle reconstruction using hamstring tendon
Goki Kamei1, Atsuo Nakamae2, Masakazu Ishikawa3
1Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, Japan. go_k_0127@yahoo.co.jp.
Purpose:
In revision anterior cruciate ligament reconstruction (ACLR), our procedure of choice is the over-the-top route (OTTR) for cases where it is difficult to use a primary bone tunnel or to create a new bone tunnel due to the enlargement or malposition of the bone tunnel. Depending on the condition of the primary bone tunnel, we choose single (bone tunnel or OTTR) or double (bone tunnel or anteromedial (AM) bundle: OTTR /posterolateral (PL) bundle: bone tunnel) for femoral fixation. This study showed the results of single and double OTTR revision ACLR using the hamstring tendon.
Methods:
Seventy-eight patients, who underwent revision ACLR using the hamstring tendon and who could be followed up for more than 2 year, were included in this study. The methods of revision ACLR were single in 54 cases (bone tunnel: 24 cases; OTTR method: 30 cases) and double in 24 cases (bone tunnel: 16 cases; OTTR for AM bundle and bone tunnel for PL bundle: eight cases). The cause of re-injury, the meniscus and cartilage injury, the reconstruction method, and the Lysholm score, Lachman test, Pivot-shift test, and the side-to-side difference in the tibial anterior translation were evaluated before and after surgery.
Results:
There was no statistically significant difference in the Lyshom score, Lachman / Pivotshift test and side-to-side difference anterior translation of the tibia between the four groups.
Conclusions:
The clinical results of single and double OTTR revision ACLR are equivalent to those of anatomic single and double bone tunnel procedures.
