In vitro and intraoperative laxities after single-bundle and double-bundle anterior cruciate ligament reconstructions

Hemanth R. Gadikota, Jong Keun Seon, Chih Hui Chen, Jia Lin Wu, Thomas J. Gill, Guoan Li

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Purpose: The purpose of this study was to objectively evaluate whether double-bundle anterior cruciate ligament (ACL) reconstruction can better restore the normal translational and rotational laxities than the conventional single-bundle ACL reconstruction among the reported biomechanical studies. Methods: A systematic literature search was conducted to identify in vitro and in vivo (intraoperative) biomechanical studies that compared the laxities (anterior or anteroposterior or rotational) between single- and double-bundle ACL reconstructions. Because of large variability among the loading conditions and testing methods used to determine the rotational laxities among the studies, a meta-analysis of rotational laxities was not feasible. Results: Seven in vitro and three in vivo studies were included in this analysis based on the predefined inclusion criteria. The overall mean differences calculated by the random effects model in anteroposterior laxity between the single-bundle and double-bundle ACL reconstruction techniques at 0°, 30°, 60°, and 90° of flexion were 0.99 mm, 0.38 mm, 0.34 mm, and 0.07 mm, respectively. No statistically significant difference was noted between the 2 treatments at all flexion angles. Among the 9 studies that compared the rotational laxity of single-bundle and double-bundle ACL reconstructions, 4 reported that double-bundle reconstruction can provide better rotational control than single-bundle reconstruction. The other 5 studies could not identify any significant difference between the 2 reconstructions in terms of rotational laxity. Conclusions: Both single- and double-bundle treatment options for ACL injury result in similar anteroposterior knee joint laxity at time 0. No conclusive evidence on the superiority of 1 reconstruction technique over the other in terms of rotation laxity can be obtained because of several variations in the experimental protocol and the kinematics used to measure the rotational laxity among the studies. Level of Evidence: Level III, meta-analysis.

Original languageEnglish
Pages (from-to)849-860
Number of pages12
JournalArthroscopy - Journal of Arthroscopic and Related Surgery
Volume27
Issue number6
DOIs
Publication statusPublished - Jun 2011
Externally publishedYes

Fingerprint

Anterior Cruciate Ligament Reconstruction
Meta-Analysis
Joint Instability
Knee Joint
Biomechanical Phenomena
In Vitro Techniques
Therapeutics

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

In vitro and intraoperative laxities after single-bundle and double-bundle anterior cruciate ligament reconstructions. / Gadikota, Hemanth R.; Seon, Jong Keun; Chen, Chih Hui; Wu, Jia Lin; Gill, Thomas J.; Li, Guoan.

In: Arthroscopy - Journal of Arthroscopic and Related Surgery, Vol. 27, No. 6, 06.2011, p. 849-860.

Research output: Contribution to journalArticle

Gadikota, Hemanth R. ; Seon, Jong Keun ; Chen, Chih Hui ; Wu, Jia Lin ; Gill, Thomas J. ; Li, Guoan. / In vitro and intraoperative laxities after single-bundle and double-bundle anterior cruciate ligament reconstructions. In: Arthroscopy - Journal of Arthroscopic and Related Surgery. 2011 ; Vol. 27, No. 6. pp. 849-860.
@article{4109085106a04f70bfa70844db9a9a9d,
title = "In vitro and intraoperative laxities after single-bundle and double-bundle anterior cruciate ligament reconstructions",
abstract = "Purpose: The purpose of this study was to objectively evaluate whether double-bundle anterior cruciate ligament (ACL) reconstruction can better restore the normal translational and rotational laxities than the conventional single-bundle ACL reconstruction among the reported biomechanical studies. Methods: A systematic literature search was conducted to identify in vitro and in vivo (intraoperative) biomechanical studies that compared the laxities (anterior or anteroposterior or rotational) between single- and double-bundle ACL reconstructions. Because of large variability among the loading conditions and testing methods used to determine the rotational laxities among the studies, a meta-analysis of rotational laxities was not feasible. Results: Seven in vitro and three in vivo studies were included in this analysis based on the predefined inclusion criteria. The overall mean differences calculated by the random effects model in anteroposterior laxity between the single-bundle and double-bundle ACL reconstruction techniques at 0°, 30°, 60°, and 90° of flexion were 0.99 mm, 0.38 mm, 0.34 mm, and 0.07 mm, respectively. No statistically significant difference was noted between the 2 treatments at all flexion angles. Among the 9 studies that compared the rotational laxity of single-bundle and double-bundle ACL reconstructions, 4 reported that double-bundle reconstruction can provide better rotational control than single-bundle reconstruction. The other 5 studies could not identify any significant difference between the 2 reconstructions in terms of rotational laxity. Conclusions: Both single- and double-bundle treatment options for ACL injury result in similar anteroposterior knee joint laxity at time 0. No conclusive evidence on the superiority of 1 reconstruction technique over the other in terms of rotation laxity can be obtained because of several variations in the experimental protocol and the kinematics used to measure the rotational laxity among the studies. Level of Evidence: Level III, meta-analysis.",
author = "Gadikota, {Hemanth R.} and Seon, {Jong Keun} and Chen, {Chih Hui} and Wu, {Jia Lin} and Gill, {Thomas J.} and Guoan Li",
year = "2011",
month = "6",
doi = "10.1016/j.arthro.2010.12.003",
language = "English",
volume = "27",
pages = "849--860",
journal = "Arthroscopy - Journal of Arthroscopic and Related Surgery",
issn = "0749-8063",
publisher = "W.B. Saunders Ltd",
number = "6",

}

TY - JOUR

T1 - In vitro and intraoperative laxities after single-bundle and double-bundle anterior cruciate ligament reconstructions

AU - Gadikota, Hemanth R.

AU - Seon, Jong Keun

AU - Chen, Chih Hui

AU - Wu, Jia Lin

AU - Gill, Thomas J.

AU - Li, Guoan

PY - 2011/6

Y1 - 2011/6

N2 - Purpose: The purpose of this study was to objectively evaluate whether double-bundle anterior cruciate ligament (ACL) reconstruction can better restore the normal translational and rotational laxities than the conventional single-bundle ACL reconstruction among the reported biomechanical studies. Methods: A systematic literature search was conducted to identify in vitro and in vivo (intraoperative) biomechanical studies that compared the laxities (anterior or anteroposterior or rotational) between single- and double-bundle ACL reconstructions. Because of large variability among the loading conditions and testing methods used to determine the rotational laxities among the studies, a meta-analysis of rotational laxities was not feasible. Results: Seven in vitro and three in vivo studies were included in this analysis based on the predefined inclusion criteria. The overall mean differences calculated by the random effects model in anteroposterior laxity between the single-bundle and double-bundle ACL reconstruction techniques at 0°, 30°, 60°, and 90° of flexion were 0.99 mm, 0.38 mm, 0.34 mm, and 0.07 mm, respectively. No statistically significant difference was noted between the 2 treatments at all flexion angles. Among the 9 studies that compared the rotational laxity of single-bundle and double-bundle ACL reconstructions, 4 reported that double-bundle reconstruction can provide better rotational control than single-bundle reconstruction. The other 5 studies could not identify any significant difference between the 2 reconstructions in terms of rotational laxity. Conclusions: Both single- and double-bundle treatment options for ACL injury result in similar anteroposterior knee joint laxity at time 0. No conclusive evidence on the superiority of 1 reconstruction technique over the other in terms of rotation laxity can be obtained because of several variations in the experimental protocol and the kinematics used to measure the rotational laxity among the studies. Level of Evidence: Level III, meta-analysis.

AB - Purpose: The purpose of this study was to objectively evaluate whether double-bundle anterior cruciate ligament (ACL) reconstruction can better restore the normal translational and rotational laxities than the conventional single-bundle ACL reconstruction among the reported biomechanical studies. Methods: A systematic literature search was conducted to identify in vitro and in vivo (intraoperative) biomechanical studies that compared the laxities (anterior or anteroposterior or rotational) between single- and double-bundle ACL reconstructions. Because of large variability among the loading conditions and testing methods used to determine the rotational laxities among the studies, a meta-analysis of rotational laxities was not feasible. Results: Seven in vitro and three in vivo studies were included in this analysis based on the predefined inclusion criteria. The overall mean differences calculated by the random effects model in anteroposterior laxity between the single-bundle and double-bundle ACL reconstruction techniques at 0°, 30°, 60°, and 90° of flexion were 0.99 mm, 0.38 mm, 0.34 mm, and 0.07 mm, respectively. No statistically significant difference was noted between the 2 treatments at all flexion angles. Among the 9 studies that compared the rotational laxity of single-bundle and double-bundle ACL reconstructions, 4 reported that double-bundle reconstruction can provide better rotational control than single-bundle reconstruction. The other 5 studies could not identify any significant difference between the 2 reconstructions in terms of rotational laxity. Conclusions: Both single- and double-bundle treatment options for ACL injury result in similar anteroposterior knee joint laxity at time 0. No conclusive evidence on the superiority of 1 reconstruction technique over the other in terms of rotation laxity can be obtained because of several variations in the experimental protocol and the kinematics used to measure the rotational laxity among the studies. Level of Evidence: Level III, meta-analysis.

UR - http://www.scopus.com/inward/record.url?scp=79957921107&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79957921107&partnerID=8YFLogxK

U2 - 10.1016/j.arthro.2010.12.003

DO - 10.1016/j.arthro.2010.12.003

M3 - Article

VL - 27

SP - 849

EP - 860

JO - Arthroscopy - Journal of Arthroscopic and Related Surgery

JF - Arthroscopy - Journal of Arthroscopic and Related Surgery

SN - 0749-8063

IS - 6

ER -