2021 ISAKOS Biennial Congress Paper
PROSPECTIVE RANDOMIZED STUDY: Double-bundle against single-bundle ACL reconstruction using allografts
Edmundo Berumen Nafarrate, PhD, Prof., CHIHUAHUA, CHIHUAHUA MEXICO
Carlos Alejandro Vega Najera, MD, Chihuahua, Chihuahua MEXICO
Joel Alejandro Cabral, MD, Chihuahua , Chihuahua MEXICO
Jesus Javier Tonche, MD, Chihuahua MEXICO
Ivan Ramos Moctezuma, Eng, Chihuahua, Chihuahua MEXICO
Luis Sigala Gonzalez, Eng, Chihuahua MEXICO
Avril Pérez Fontes, MD, Chihuahua MEXICO
Fatima Quintana Trejo, Eng, Chihuahua, Chihuahua MEXICO
Carlos Leal, MD, Prof., Bogota, DC COLOMBIA
Christus Mugerza Hospital del Parque, Chihuahua, Chihuahua, MEXICO
The FDA has not cleared the following pharmaceuticals and/or medical device for the use described in this presentation. The following pharmaceuticals and/or medical device are being discussed for an off-label use: Ortopedia Chihuahua, Pivot Shift Meter
Summary
The “U-Dos” double bundle ACL allograft reconstruction technique has better rotational stability outcomes than the single bundle ACL allograft reconstruction.
Abstract
PROSPECTIVE RANDOMIZED STUDY: Double bundle against single-bundle ACL reconstruction using allografts
Carlos Alejandro Vega Nájera, Joel Cabral Guzmán, Luis Raúl Sigala González, Avril Pérez Fontes, Jesús Javier Tonche Ramos, Iván René Ramos Moctezuma, Fátima Norely Quintana Trejo, Carlos Leal Contreras, Edmundo Berumen Nafarrate
Christus Muguerza del Parque Hospital, Chihuahua, México.
Background
The knee is a synovial joint that in the normal activity of life is subjected to a lot of stress. But in sports, these forces push the knee to the limit and sometimes cause a wide variety of injuries. Anterior cruciate ligament (ACL) injuries are very common among athletes. If these injuries are not repaired, meniscus and cartilage injuries will occur and very rapid wear and tear will occur.
Material And Methods
A prospective randomized study was conducted during September 2016 and June 2018 to evaluate ACL reconstructions using double and single beam ACL reconstruction surgical techniques in a group of 72 previously healthy, active patients with acute injury to the ACL with a similar injury mechanism in all cases. This study was reviewed and accepted by the research and ethics committee of the Christus Muguerza del Parque Hospital. An ACL injury was documented using the IKDC and Tegner Lysholm clinical scales, measurement equipment such as KT1000 and the Pivot-Shift Meter application (PSM) before the operation, complemented with an imaging study, magnetic resonance (MRI), all lesions were evaluated with these instruments just before and after the operation and as a follow-up at 2, 4, 6, 12 months and 2 years. Before surgery, a blind envelope was opened to decide which surgical technique to use.
Results
72 patients were randomized, distributing 36 patients in each group. The double-bundle group had a less repeated ACL tear, fewer meniscal injuries, and better Lysholm and IKDC scores. This technique also had a better measurement on the KT-1000 and a more stable knee with the PSM.
Conclusion
After a follow-up of more than two years, , it was found that the double-bundle (DB) ACL group had significantly better results than the group that underwent the single-bundle (SB) surgical technique.
The double-bundle technique is better in a short and medium-term follow-up (two years), since the recovery of patients is better using this technique, the results in clinical scales are better, the patients present less difference in anteroposterior displacement in millimeters using the KT-1000 relative to your healthy knee and a downgrade using PSM. Patients can return to their pre-injury activities faster using the double beam technique.
Level of Evidence: Case - Control Study