Short Term Effectiveness Analysis Of Double-bundle Double-Tunnel Arthroscopy Anterior Cruciate Ligament Reconstruction With Deep-frozen Allografts

0bjective： To compare the clinical effectiveness and complication incidencebetween arthroscopic double-bundle double-tunnel and traditional single-tunnelanterior cruciate ligament(ACL) reconstruction with deep—frozen allografts.Methods：Between October2010and October2010,48male patients aged from21to32(average25) undergoing ACL injury due to military training from ourdepartment are characteristic of pain, Instability and anterior drawer test(ADT)，Lachman test (+) in knee joint before operation. All patients were divided into A(single-tunnel allogeneic autologous tendon) group (n=16); B (single-tunnel allogeneictendon) group (n=16); C(double-tunnel double-bundle allogeneic tendon) group (n=16)according to different reconstruction methods. There was no significant difference inage， injury cause,disease duration and so on before operations among3groups(P>0．05). All the ACL reconstruction operations were completed by the sameteam. After ACL reconstruction operations, the patients of3groups whose affectedlimb was fixed by brace and did rehabilitation exercise according to the same method.Patients were evaluated preoperatively and postoperatively from3month--14month.Before and after ACL reconstruction operation, function of knee jiont of each patientwas evaluated according to anterior drawer test(ADT), Lachman test, pivot shift test,international knee documental committee (IKDC)score, and Lysholm score in order toobserve the indexes of function and stability of knee joint.Compare the clinicaleffectiveness and short and long term complication incidence in different ACLreconstructions and make a statistical analysis to the results.Result：All the patients were followed up as scheduled. The paired t test and X2analysis results of IKDC score,Lysholm score, ADT,Lachman test, pivot shift testshow that after operation was much more improved than before operation and there was significant difference（P<0.05）.At the last follow-up,there were no significantdifferences between the double-tunnel group and single-tunnel group in clinicaleffectiveness (P>0.05)．However,it was worth mentioning that there was differencein good degree of proprioception and time of recovering normal living and sportbetween2groups(p<0.05).The group of double-bundle double-tunnel was earlier andbetter than the single-tunnel group.There was no remarkable difference in complicationincidence rate.None of48cases was suffered from infection,deep venousthrombosis(DVT) and facture,etc complications. But, at the last follow-up,the anteriordrawer test was rated as++and the pivot shift test were rated as+in A group(2cases，12.5%),B group(4cases，25%),and C group(4cases，25%),which patients did not feelpain and instability of knee joint.So they were not carried revision operation. In single-tunnel group, there were not obviously different between allogeneic autologous tendonand allogeneic tendo in clinical effectiveness and complication incidence.Conclusion：The double-bundle double-tunnel ACL reconstruction is probablybetter to restore ACL anatomy structure and stability. But there was not obviousadvantage in short term on clinical effectiveness, and was necessary to make furtherfollow-up in long term. Moreover the former need harder operation technique and morepracticed skills. It needs to consider about many factors such as more operation-time,more cost and harder ACL revision,etc. So orthopedists need to make aIndividualized analysis and a further research on the problem that what and which isthe better and more suitable ACL reconstruction operation method.