One Year Follow Up of Arthroscopic Double Bundle ACL Reconstruction with Internal Bracing

Introduction: Anatomically anterior cruciate ligament (ACL) consists of two bundles, anteromedial and posterolateral bundle. These two bundles play different roles in biomechanics and stability of knee joint. (1) As the knee flexes, anteromedial bundle tightens and posterolateral bundle is relatively lax. In knee extension the posterolateral bundle tightens (1). The essence of anatomical double bundle ACL reconstruction lies in reproducing the natural anatomy of ACL and hence the natural biomechanics.

Purpose: To asses results of one year follow up of double bundle ACL reconstruction with internal bracing.

Methods:  Retrospective evaluation of results of double bundle ACL reconstruction with internal bracing. Total 100 knees were included in this study. All patients met our inclusion criteria and the results were evaluated by Tegner Lysholm Knee Scoring Scale and lachman test at the end of one year.

Results:  At the end of one year the average Tegner Lysholm Knee Scoring Scale increased from a pre op value of 52 (39 to 58) to a post op value of 89 at the end of one year. (74 to 94). All patients demonstrated a negative lachman’s test. Three patients had flexion deformity between 5 to 10 degrees. Ten patients missed follow up. 15 patients had more than 15-degree loss of motion. One patient complained of abnormal painless clicking sensation. None of the patients were reoperated. None of the patients had infection.

Conclusions: double bundle ACL reconstruction is worth recommending for patients. Its technically demanding. Although, at present Superiority of this technique from conventional single bundle ACL reconstruction is not established but theoretically it reproduces natural knee kinemetics and biomechanics by reconstructing the natural anatomy of ACL. Internal bracing may protect the newly reconstructed ACL bundles from trauma in early post op period.