|
Hokkaido University Collection of Scholarly and Academic Papers >
Graduate School of Medicine / Faculty of Medicine >
Peer-reviewed Journal Articles, etc >
Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction
| Title: | Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction |
| Authors: | Yasuda, Kazunori Browse this author →KAKEN DB | | Tanabe, Yoshie Browse this author | | Kondo, Eiji Browse this author →KAKEN DB | | Kitamura, Nobuto Browse this author | | Tohyama, Harukazu Browse this author |
| Issue Date: | Sep-2010 |
| Publisher: | Elsevier |
| Journal Title: | Arthroscopy : The Journal of Arthroscopic & Related Surgery |
| Volume: | 26 |
| Issue: | 9, Suppl. 1 |
| Start Page: | S21 |
| End Page: | S34 |
| Publisher DOI: | 10.1016/j.arthro.2010.03.014 |
| PMID: | 20810091 |
| Abstract: | Several double-bundle anterior cruciate ligament (ACL) reconstruction procedures were reported in the 1980s and 1990s. However, no significant differences were found in the clinical results between these double-bundle procedures and single-bundle procedures because the double-bundle procedures appeared to reconstruct only the anteromedial bundle with two bundles. In the early 2000s, the authors proposed a new concept of anatomic reconstruction of the anteromedial and posterolateral bundles, in which 4 independent tunnels were created through the center of each anatomic attachment of the 2 bundles. We named it "anatomic" double-bundle ACL reconstruction. Biomechanical studies have shown that the anatomic double-bundle ACL reconstruction can restore knee stability significantly closer to the normal level than the conventional single-bundle reconstruction. Recent intraoperative measurement studies have showed that the clinically available anatomic double-bundle procedures can reconstruct knee stability significantly better and improve knee function close to the normal level at the time immediately after surgery than the conventional single-bundle procedures. However, the greatest criticism of the anatomic double-bundle reconstruction is whether the clinical results of anatomic double-bundle reconstruction are better than the results of single-bundle reconstruction. Currently, 10 prospective comparative clinical trials (Level I or II) and 1 meta-analysis have been reported to date (January, 2010) that compare single-bundle and anatomic double-bundle reconstructions using hamstring tendons. In 8 of the 10 studies, the anterior and/or rotatory stability of the knee was significantly better in the anatomic double-bundle ACL reconstruction than the conventional single-bundle reconstruction. However, 1 original trial and the meta-analysis found that there were no differences in the results between the 2 types of reconstructions. Thus, the utility of the anatomic double-bundle reconstruction has not yet been established. Our systematic review shows how much evidence exists as to the benefits of double-bundle ACL reconstruction at the present time. |
| Type: | article (author version) |
| URI: | http://hdl.handle.net/2115/43946 |
| Appears in Collections: | 医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
|
Submitter: 安田 和則
|
