ACL repair with a single or double tunnel : a comparative laboratory study of knee stability using computer navigation


Published online: Dec 27 2012

Luk VERHELST, Hans VAN DER BRACHT, Dirk OOSTERLINCK, Johan BELLEMANS

From the Catholic University Hospital Leuven, Pellenberg, Belgium and AZ Groeninge, Kortrijk, Belgium

Abstract

The purpose of the study was to investigate the biomechanical differences between single bundle (SB), single tunnel-twisted hamstring graft (ST-TG) and double bundle (DB) reconstruction of the anterior cruciate ligament (ACL), using computer navigation for data acquisition. Anterior translation in the medial compartment was corrected to near normal levels at 30° and 90° with all techniques. Anterior translation in the lateral compartment was corrected to near normal levels at 30° and 90°. However, the ST-TG and the DB were overcorrected to below-preoperative levels. The DB significantly overconstrained internal rotation at different angles. Anterior translation in the lateral compartment on maximum internal rotation was significantly overconstrained using a DB. We conclude that ACL reconstruction restores near normal knee kinematics. Our data suggest that the ST-TG and the DB better control anterior translation in the lateral compartment. It also suggests that DB caries a risk of overcorrection. This study has a small sample size and should be considered as a pilot study.