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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 1/2012

01-01-2012 | Knee

Triple-bundle ACL grafts evaluated by second-look arthroscopy

Authors: Yoshinari Tanaka, Konsei Shino, Shuji Horibe, Norimasa Nakamura, Shigeto Nakagawa, Tatsuo Mae, Hidenori Otsubo, Tomoyuki Suzuki, Ken Nakata

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 1/2012

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Abstract

Purpose

The purpose of this study was to evaluate the morphology of transplanted triple-bundle anterior cruciate ligament (ACL) grafts by second-look arthroscopy.

Methods

The subjects were 41 patients with a mean age of 25.5 ± 8.5 years who underwent second-look arthroscopy at between 6 and 22 months after the anatomical triple-bundle ACL reconstruction using semitendinosus tendon autograft. Lachman test was negative in 38 knees and mildly positive with a firm endpoint in 3 knees. Arthroscopic evaluation of grafts was performed for the anteromedial graft (AM), the intermediate graft (IM), and the posterolateral graft (PL), focusing on tension and graft damage.

Results

All grafts showed “fan-out” shape approaching the tibial attachment, which looked closer to the natural ACL compared to the double-bundle grafts. As to graft tension, 93% of AM, 90% of IM, and 88% of PL grafts were evaluated as taut, respectively. As to graft damage, there was no apparent rupture in the AM and IM grafts, while complete or substantial rupture was observed in 10% of PL grafts around the femoral tunnel aperture. The incidence of graft rupture in PL grafts was significantly greater than those in the AM and IM grafts. As to synovial coverage, 76% of AM, 78% of IM, and 59% of PL grafts were evaluated as “Good,” while 41% of PL grafts were not fully covered with synovium. All of the synovial defects were observed around the femoral tunnel aperture.

Conclusion

The morphology of the triple-bundle grafts resembled that of the natural ACL, while complete or substantial rupture was observed in 10% of the PL grafts.

Level of evidence

Study of case series with no comparison group, Level IV.
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Metadata
Title
Triple-bundle ACL grafts evaluated by second-look arthroscopy
Authors
Yoshinari Tanaka
Konsei Shino
Shuji Horibe
Norimasa Nakamura
Shigeto Nakagawa
Tatsuo Mae
Hidenori Otsubo
Tomoyuki Suzuki
Ken Nakata
Publication date
01-01-2012
Publisher
Springer-Verlag
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 1/2012
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-011-1551-8

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