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Double-Tunnel Anatomic Anterior Cruciate Ligament Reconstruction

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Sports Injuries

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Abstract

In the early 2000s, a new concept of anatomic reconstruction of the anteromedial and posterolateral bundles of the anterior cruciate ligament (ACL), in which four independent tunnels were created through the center of each anatomic attachment of the two bundles, was proposed. Biomechanical studies have shown that the anatomic double-bundle ACL reconstruction can restore knee stability significantly more closely to the normal level than the conventional single-bundle reconstruction. In clinical evaluations, the anterior and/or rotatory stability of the knee was significantly better with the anatomic double-bundle ACL reconstruction than with the conventional single-bundle reconstruction. To establish the clinical utility of the anatomic double-bundle ACL reconstruction, further clinical studies are needed concerning the effects on rotatory stability, long-term survival of the graft functions, and comparisons with other procedures.

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Abbreviations

ACL:

Anterior cruciate ligament

AM:

Anteromedial bundle

PL:

Posterolateral bundles

References

  • Adachi N, Ochi M, Uchio Y et al (2004) Reconstruction of the anterior cruciate ligament. Single- versus double-bundle multistranded hamstring tendons. J Bone Joint Surg (Br) 86:515–520

    Article  CAS  Google Scholar 

  • Aglietti P, Giron F, Cuomo P et al (2007) Single- and double-incision double-bundle ACL reconstruction. Clin Orthop Relat Res 454:108–113

    Article  Google Scholar 

  • Amis A, Dawkins GPC (1991) Functional anatomy of the anterior cruciate ligament: fiber bundle actions related to ligament replacement and injuries. J Bone Joint Surg (Br) 73:260–267

    Article  CAS  Google Scholar 

  • Hamada M, Shino K, Horibe S et al (2001) Single- versus bisocket anterior cruciate ligament reconstruction using autogenous multiple-stranded hamstring tendons with Endobutton femoral fixation: a prospective study. Arthroscopy 17:801–807

    Article  CAS  Google Scholar 

  • Inagaki Y, Kondo E, Kitamura N et al (2013) Prospective clinical comparisons of semitendinosus versus semitendinosus and gracilis tendon autografts for anatomic double-bundle anterior cruciate ligament reconstruction. J Orthop Sci 18:754–761

    Article  Google Scholar 

  • Jarvela T, Moisala AS, Sihvonen R et al (2008) Double-bundle anterior cruciate ligament reconstruction using hamstring autografts and bioabsorbable interference screw fixation: prospective, randomized clinical study with two-year results. Am J Sports Med 36:290–297

    Article  Google Scholar 

  • Kai S, Kondo E, Kitamura N et al (2013) A quantitative technique to create a femoral tunnel at the averaged center of the anteromedial bundle attachment in anatomic double-bundle anterior cruciate ligament reconstruction. BMC Musculoskelet Disord 14:189

    Article  Google Scholar 

  • Kondo E, Yasuda K (2007) Second-look arthroscopic evaluations of anatomic double-bundle anterior cruciate ligament reconstruction: relation with postoperative knee stability. Arthroscopy 23:1198–1209

    Article  Google Scholar 

  • Kondo E, Yasuda K, Ichiyama H et al (2007) Radiologic evaluation of femoral and tibial tunnels created with the transtibial tunnel technique for anatomic double-bundle anterior cruciate ligament reconstruction. Arthroscopy 23:869–876

    Article  Google Scholar 

  • Kondo E, Yasuda K, Azuma H et al (2008) Prospective clinical comparisons of anatomic double-bundle versus single-bundle anterior cruciate ligament reconstruction procedures in 328 consecutive patients. Am J Sports Med 36:1675–1687

    Article  Google Scholar 

  • Kondo E, Merican AM, Yasuda K et al (2010) Biomechanical comparisons of knee stability after anterior cruciate ligament reconstruction between 2 clinically available transtibial procedures: anatomic double bundle versus single bundle. Am J Sports Med 38:1349–1358

    Article  Google Scholar 

  • Kondo E, Yasuda K, Katsura T et al (2012a) Biomechanical and histological evaluations of the doubled semitendinosus tendon autograft after anterior cruciate ligament reconstruction in sheep. Am J Sports Med 40:315–324

    Article  Google Scholar 

  • Kondo E, Yasuda K, Miyatake S et al (2012b) Clinical comparison of two suspensory fixation devices for anatomic double-bundle anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 20:1261–1267

    Article  Google Scholar 

  • Meredick RB, Vance KJ, Appleby D et al (2008) Outcome of single-bundle versus double-bundle reconstruction of the anterior cruciate ligament: a meta-analysis. Am J Sports Med 36:1414–1421

    Article  Google Scholar 

  • Mott HW (1983) Semitendinosus anatomic reconstruction for cruciate ligament insufficiency. Clin Orthop Relat Res 172:90–92

    Article  Google Scholar 

  • Muneta T, Sekiya I, Yagishita K et al (1999) Two-bundle reconstruction of the anterior cruciate ligament using semitendinosus tendon with Endobuttons: operative technique and preliminary results. Arthroscopy 15:618–624

    Article  CAS  Google Scholar 

  • Muneta T, Koga H, Mochizuki T et al (2007) A prospective randomized study of 4-strand semitendinosus tendon anterior cruciate ligament reconstruction comparing single-bundle and double-bundle techniques. Arthroscopy 23:618–628

    Article  Google Scholar 

  • Sakane M, Fox RJ, Woo SL et al (1997) In situ forces in the anterior cruciate ligament and its bundles in response to anterior tibial loads. J Orthop Res 15:285–293

    Article  CAS  Google Scholar 

  • Siebold R, Dehler C, Ellert T (2008) Prospective randomized comparison of double-bundle versus single-bundle anterior cruciate ligament reconstruction. Arthroscopy 24:137–145

    Article  Google Scholar 

  • Streich NA, Friedrich K, Gotterbarm T et al (2008) Reconstruction of the ACL with a semitendinosus tendon graft: a prospective randomized single blinded comparison of double bundle versus single-bundle technique in male athletes. Knee Surg Sports Traumatol Arthrosc 16:232–238

    Article  Google Scholar 

  • Tohyama H, Kondo E, Hayashi R et al (2011) Gender-based differences in outcome after anatomic double-bundle anterior cruciate ligament reconstruction with hamstring tendon autografts. Am J Sports Med 39:1849–1857

    Article  Google Scholar 

  • Yagi M, Kuroda R, Nagamune K et al (2007) Double bundle ACL reconstruction can improve rotational stability. Clin Orthop Relat Res 454:100–107

    Article  Google Scholar 

  • Yasuda K, Tsujino J, Ohkoshi Y et al (1995) Graft site morbidity with autogenous semitendinosus and gracilis tendons. Am J Sports Med 23:706–714

    Article  CAS  Google Scholar 

  • Yasuda K, Tsujino J, Tanabe Y et al (1997) Effects of initial graft tension on clinical outcome after anterior cruciate ligament reconstruction: autogenous doubled hamstring tendons connected in series with polyester tapes. Am J Sports Med 25:99–106

    Article  CAS  Google Scholar 

  • Yasuda K, Kondo E, Ichiyama H et al (2004) Anatomical reconstruction of the anteromedial and posterolateral bundles of the anterior cruciate ligament using hamstring tendon grafts. Arthroscopy 20:1015–1025

    Article  Google Scholar 

  • Yasuda K, Kondo E, Ichiyama H et al (2006) Clinical evaluation of anatomic double-bundle anterior cruciate ligament reconstruction procedure using hamstring tendon grafts: comparisons among 3 different procedures. Arthroscopy 22:240–251

    Article  Google Scholar 

  • Yasuda K, Ichiyama H, Kondo E et al (2008) An in vivo biomechanical study on the tension-versus-knee flexion angle curves of 2 grafts in anatomic double-bundle anterior cruciate ligament reconstruction: effects of initial tension and internal tibial rotation. Arthroscopy 24:276–284

    Article  Google Scholar 

  • Zaricznyj B (1987) Reconstruction of the anterior cruciate ligament of the knee using a doubled tendon graft. Clin Orthop Relat Res 220:162–175

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Advanced Therapeutic Research for Sports Medicine, Hokkaido University, Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, Japan

    Eiji Kondo

  2. Department of Sports Medicine and Joint Surgery, Hokkaido University, Graduate School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo, Hokkaido, Japan

    Kazunori Yasuda

Authors
  1. Eiji Kondo
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  2. Kazunori Yasuda
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Corresponding author

Correspondence to Eiji Kondo .

Editor information

Editors and Affiliations

  1. Department of Orthopaedics and Traumatology and Department of Sports Medicine, Hacettepe University, Istanbul, Turkey

    Mahmut Nedim Doral

  2. Department of Orthopaedic Surgery, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden

    Jon Karlsson

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Kondo, E., Yasuda, K. (2015). Double-Tunnel Anatomic Anterior Cruciate Ligament Reconstruction. In: Doral, M.N., Karlsson, J. (eds) Sports Injuries. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-36569-0_92

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  • DOI: https://doi.org/10.1007/978-3-642-36569-0_92

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-36568-3

  • Online ISBN: 978-3-642-36569-0

  • eBook Packages: MedicineReference Module Medicine

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