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  • Title: One- versus two-incision technique for anterior cruciate ligament reconstruction with patellar tendon graft. Results on early rehabilitation and stability.
    Author: Gerich TG, Lattermann C, Fremerey RW, Zeichen J, Lobenhoffer HP.
    Journal: Knee Surg Sports Traumatol Arthrosc; 1997; 5(4):213-6. PubMed ID: 9430569.
    Abstract:
    Anterior cruciate ligament (ACL) reconstruction with patellar tendon graft has become a standard procedure. The graft can be inserted either using two tunnels and a lateral femoral incision or with a femoral half-tunnel drilled from the joint, thus avoiding the lateral incision. Advantages have been claimed for the single-incision technique in the early rehabilitation period. Forty patients with ACL deficiency were included in a prospective randomized trial comparing the single- and two-incision technique with a follow-up period of 12 months. Preoperative data did not show any significant difference between the two groups. At early follow-up no differences were observed with respect to complications or the progress of rehabilitation. Evaluation at 12 months postoperatively using the IKDC form revealed good to excellent results in 70% of patients. ACL reconstruction reduced anterior translation of the knee significantly at the 6-month and 12-month follow-up with a slight increase of MMD values at 12 months in both groups. The arthroscopic single-incision technique did not differ from the mini-open technique in terms of postoperative pain medication, incidence of effusion, postoperative range-of-motion or any rehabilitation parameters. Stability was comparable in both groups at all time periods. We conclude that an arthroscopic single-incision technique has no advantage over a mini-open two-incision technique for ACL reconstruction with patellar tendon graft in terms of subjective or objective parameters.
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