Single-versus two-incision technique in anterior cruciate ligament replacement: influence on postoperative muscle function.

Abstract

The purpose of this study was to find out whether the single-incision technique for anterior cruciate ligament repair has advantages over the two-incision technique in terms of muscular function up to 1 year postoperatively. Twenty patients who underwent unilateral anterior cruciate ligament reconstruction with bone-patellar tendon-bone autografts were randomly assigned to one of the two procedures. Both groups (10 patients in each) were followed up at 1 year. Lysholm and International Knee Documentation scores and thigh circumferences were markedly reduced after surgery in both groups but improved up until the last follow-up examination at 12 months postoperatively. Clinical examination, functional scores, stabilometry measurements, and thigh circumferences did not differ between the two groups. Isokinetic evaluation revealed a significant reduction of extensor peak torques in both groups that was most pronounced at 3 months, then improved continuously but was still present 12 months postoperatively. A significant reduction of peak torques, up to 35%, was seen in the flexor muscles of the involved legs compared with the contralateral legs, but this deficit vanished completely after 12 months in both groups. At 3 and 6 months, for the flexor as well as the extensor muscles, the deficits in peak torque on the injured sides were found to have improved faster in the single-incision group. These results indicate improved dynamic muscle function with use of the single-incision technique because the dissection of the vastus lateralis muscle that occurs in the two-incision technique is avoided.