Two Can Equal One in ACL Surgery

ACL surgery techniques using double versus single bundle ligaments provide equal stability

(RxWiki News) Surgery for a blown anterior cruciate ligament (ACL) inside the knee is becoming more and more common. New techniques to perform the surgery are on the rise across the country.

Damaged ACLs that were replaced using a double-bundle technique during surgery were as stable as patients who received the single-bundle technique, according to a study presented at a conference.

In double-bundle, the new ligament has two parts whereas the single bundle just has one.

One ACL surgery technique did not provide more knee stability than another, according to researchers, though the results have yet to be peer reviewed.

"Complete physical therapy after surgery."

In ACL surgery, a tendon is taken from another part of the body and inserted into the knee to replace the damaged ACL. Researchers investigated two different ACL surgery techniques and whether one provided more knee stability than another.

The study, led by Mattias Ahlden, MD, from Sahlgrenska University Hospital in Mölndal, Sweden, included 98 patients between 18 and 52 years of age with damaged ACLs.

A little more than half the patients received the double-bundle technique, in which the new tendon contains two functional parts, or bundles.

The other half received the more common single-bundle technique, in which the new tendon has one single bundle.

A number of stability tests were performed on the patients' knees, including the pivot shift test, range of motion, one-legged hop test and square-hop test.

Patients were tested before surgery and more than two years after the procedure by an independent researcher who did not know which procedure the patients had.

Two years after surgery, researchers found stability scores were the same in both groups of patients. Members of both groups were more stable than they were before surgery.

"Our study was not intended to show the overall effectiveness of ACL surgery, but instead determine if one surgical approach is better than another in promoting a return to normal activity," Dr. Ahldén said in a press release.

"The data shows that in fact multiple surgical approaches can help patients enjoy a return to normalcy after knee injuries."

Researchers did not look at long-term effects of ACL injury recovery, such as osteoarthritis.

The study was presented today at the American Orthopaedic Society for Sports Medicine's Specialty Day in Chicago and has not yet been published in a peer-reviewed journal.

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Review Date: 
March 19, 2013