One-versus two-incision ACL reconstruction. A prospective, randomized study

This study compares the early functional outcomes of anterior cruciate ligament (ACL) reconstruction using a one-incision endoscopic technique versus a two-incision arthroscopically assisted technique. Thirty patients with chronic ACL-deficient knees were randomly assigned to either group 1 (one-incision technique; 15 patients) or group 2 (two-incision technique; 15 patients). Middle third ipsilateral patellar tendon was used in all reconstructions. All patients followed the same home-based accelerated rehabilitation protocol. The International Knee Documentation Committee scoring system was used to assess pre- and postoperative knee function. The mean length of follow-up was 17 months for group 1 and 15 months for group 2. Three patients were lost to follow-up in group 2. Patients in group 1 achieved a mean one-leg hop value of 89% of the uninjured side while group 2 patients averaged 92%. The mean side-to-side difference in anterior tibial translation was 2 mm in both groups at manual maximum translation. The mean isokinetic quadriceps strength at 300 degrees/second of the operated side 1 year after surgery was 83% of normal for group 1 versus 73% for group 2. Both groups achieved maximum range of motion within 3 months. There was no statistically significant difference between the outcomes of the one- and two-incision techniques for ACL reconstruction. All patients in both groups had improved stability and function of their operative knees compared with their preoperative condition.