Bi-socket ACL reconstruction using hamstring tendons: high versus low femoral socket placement.

Full Abstract

To clarify the importance of the femoral socket location in bi-socket Anterior cruciate ligament (ACL) reconstruction. Subjects included 261 patients with an average age of 26 years who received ACL reconstruction via the high-femoral socket procedure (Group H) and 43 patients with an average age of 29 years who received ACL reconstruction via the low-femoral socket procedure (Group L) with a minimal follow-up of 24 months. In Group H, the femoral sockets were created at 1:00 or 11:00 and 2:00-2:30 or 9:30-10:00 of the intercondylar notch. In Group L, the two femoral sockets were drilled at 2:00 or 10:00 and 3:00 or 9:00. For the tibial side, a single tunnel was made at the center of the footprint. Evaluation was performed based on the IKDC Knee Examination Form. While 137 knees (52%) were graded as normal, 100 (38%) as nearly normal, 8 (3%) as abnormal, and 2 (1%) as severely abnormal with 14 (5%) re-injury in Group H, 38 knees (74%) were graded as normal, and 7 (16%) as nearly normal with 3 (7%) re-injury in Group L, showing a better subjective evaluation (P = 0.007). The average side-to-side differences in anterior laxity at manual maximum force with the KT-1000 were 1.1 +/- 1.6 mm for Group H and 1.0 +/- 1.6 mm for Group L without statistically significant differences excluding re-injured cases. There were 204 patients (83%) from Group H and 33 (83%) from Group L with values between -2 and 2 mm, while 228 (92%) patients from Group H and 38 (95%) from Group L had values distributed between -3 and 3 mm. While the bi-socket ACL reconstruction provided objectively satisfactory clinical outcomes in more than 90% of the patients, the low-femoral socket placement was found to subjectively achieve better outcomes.

Author information

Author/s: Toritsuka, Yukiyoshi (Y); Amano, Hiroshi (H); Yamada, Yuzo (Y); Hamada, Masayuki (M); Mitsuoka, Tomoki (T); Horibe, Shuji (S); Shino, Konsei (K);

Affiliation: Department of Orthopaedic Sports Medicine, Kansai Rosai Hospital, 3-1-69 Inabaso, Amagasaki, Hyogo 660-0064, Japan. toritsuka(-atsign-)kanrou.net

Journal and publication information

Publication Type: Comparative Study; Journal Article

Journal: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA (Knee Surg Sports Traumatol Arthrosc), published in Germany. (Language: eng)

Reference: 2007-Jul; vol 15 (issue 7) : pp 835-46

Dates: Created 2007/07/20; Completed 2007/10/18;

PMID: 17364204, status: MEDLINE (last retrieved date: 2/18/2009)

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