Comparison Of Selective-Bundle Augmentation To Double-Bundle Reconstruction In Partial Anterior Cruciate Ligament (ACL) Ruptures

Objective: The present research was conducted to compare the outcomes of selectivebundle(SB)augmentation(Group Ⅰ)with double-bundle(DB)reconstruction(Group Ⅱ)of isolated posterolateral bundle(PLB)or anteromedial bundle(AMB)anterior cruciate ligament ruptures at 24-month follow-up.Methods: Visual Analogue Scale(VAS),International Knee Documentation Committee(IKDC-2000),Cincinnati Knee Score(CKS),Knee Injury and Osteoarthritis Outcome Score(KOOS)were assessed preoperatively and at 24-month postoperatively.Lachman test,drawer test and pivot shift test were used to determine the stability of knee joint.Findings: A total of 65 patients were recruited for the study,of whom 31 underwent elective reconstruction(group Ⅰ),including 15 in the AM group and 16 in the PL group,and the remaining 34 underwent double-bundle reconstruction(group Ⅱ).For all subjective scores,group Ⅰ patients scored significantly higher than group Ⅱ patients.However,the significant difference was observed only between IKDC and VAS scores(P < 0.05).there was no clear difference found in the knee range of motion between group Ⅰ(-1.7-130.9 °)and group Ⅱ(-1.9-128.5 °).Compared with the second group,the degree of relaxation in group Ⅰ was considerably lower(group Ⅰ(1.3 ± 0.8 mm)vs.group Ⅱ(2.4± 0.9 mm),P < 0.05).However,there were significant differences found between AM double bundle reconstruction group and PL double bundle reconstruction group,AM PL triple trial,VAS score and IKDC score compared with double bundle reconstruction.In conclusion,the patients in the selective reconstruction group(SB-ACL-R)showed improvement of scores compared with those in the double-bundle reconstruction group(DB-ACL-R).When higher scores were achieved for both surgical modalities,there were significant differences observed in IKDC and VAS.The results of drawer test,Lachman test and pivot shift test in selective reconstruction group were considered significant.Conclusions: SB-ACL-A resulted in significantly higher IKDC and VAS scores,as well as lower graded laxity.In presence of intact bundle,SB-ACL-A could be conducted in lieu of DB-ACL-R.