Over-the-top anterior cruciate ligament reconstruction using single-or double-strand hamstrings autograft

Alberto Ruffilli, Roberto Budada, Gherardo Pagagliazzi, Matteo Baldadassarri, Marco Cavallo, Deianira Luciani, Enrico Ferranti, Sandro Giannini

Research output: Contribution to journalArticle


The purpose of this study is to (1) report the long-term clinical and radiographic out-comes of a nonanatomical anterior cruciate ligament (ACL) reconstruction using an over-the-top (OTT) femoral route and (2) compare single-strand (1SHG) and double-strand (2SHG) hamstrings graft reconstruction. Fifty-one consecutive patients (mean age, 29.2±3.8 years) underwent nonanatomical ACL reconstruction using OTT femoral passage. Twenty patients underwent 1SHG reconstruction and 31 under-went 2SHG reconstruction. International Knee Documentation Committee (IKDC) score, Knee Injury and Osteoarthritis Outcome Score (KOOS), Tegner score, andKT-1000 (Medmetric Corporation, San Diego, California) evaluation were recorded at a mean follow-up of 12.1±1.6 years. At final follow-up, radiographic evalua-tion was performed according to the IKDC grading system. Mean IKDC subjective score at follow-up was 76.6±21.9 in the 1SHG group and 88.9±10.0 in the 2SHG (P=.009). Average KOOS was 82.6±18.7 in the 1SHG group and 92.4±9.2 in the 2SHG group (P=.016). Objective IKDC evaluation showed a higher percentage of normal knees in the 2SHG group (P=.018). Pivot shift testing revealed a significantly higher number of normal knees in the 2SHG group (P=.001). Radiographs showed fewer degenerative changes in the 2SHG group at final follow-up in the medial (P=.01) and lateral (P=.037) compartments. Nonanatomical ACL reconstruction us-ing the OTT technique provided satisfactory results in terms of control of both static and dynamic instability at long-term follow-up, thus preventing degenerative joint disease. The 2SHG group showed better subjective and functional outcomes with fewer degenerative changes compared with the 1SHG group at long-term follow-up.

Original languageEnglish
Pages (from-to)e635-e643
Issue number7
Publication statusPublished - Jul 1 2015

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Medicine(all)

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