Dynamic functional performance and kinematic analysis of the rotational patterns of single- versus double-bundle anterior cruciate ligament reconstruction

Abstract

BackgroundThe evaluation of anterior cruciate ligament (ACL) reconstruction has typically focused on the restoration of rotatory stability. Some studies have compared single-bundle and double-bundle ACL reconstruction using subjective clinical tests and questionnaires, but these studies only provide limited data on rotational stability. The purpose of this study is to determine the rotational patterns that present during high-demand pivoting tasks and to evaluate any difference in kinematic rotational patterns between patients who have undergone single- or double-bundle ACL reconstruction. Materials and MethodsTwenty-four males were divided into four groups for this study: intact, ACL deficient, single-bundle reconstructed, and double-bundle reconstructed. Kinematic data were collected using a 10-camera optoelectronic motion analysis system while the participants performed high-demand landing and pivoting tasks. The evaluation period was defined as the time from when the tested foot made contact with the ground to takeoff, and the range of tibial rotation was measured. ResultsRotation was significantly reduced in the single-bundle ACL reconstructed knees (7.8° ± 3.4°) and double-bundle ACL reconstructed knees (7.5° ± 2.6°) in comparison with ACL-deficient knees (13.5° ± 3.7°; p < 0.05). There was no significant difference in terms of tibial rotation between the intact knees (6.5° ± 3.5°) and the single-bundle or double-bundle ACL reconstructed knees after >2 years of follow up (p > 0.05). ConclusionBy using a dynamic functional biomechanical assessment, we demonstrate that the single-bundle ACL reconstruction technique using a composite hamstring tendon graft and the double-bundle ACL reconstruction technique can adequately restore excessive tibial rotation during high-demand activities such as landing and pivoting.