Rotational laxity after anatomical ACL reconstruction measured by 3-D motion analysis: a prospective randomized clinical trial comparing anatomic and nonanatomic ACL reconstruction techniques

Purpose To compare the ability of three different anterior cruciate ligament (ACL) reconstruction techniques to normalize rotational knee stability 1 year after ACL reconstruction. Two of these techniques are so-called anatomic techniques. Methods Three different ACL reconstruction techniques were tested for their ability to normalize rotational knee stability in a prospective randomized study. Forty-seven ACL-deficient (ACLD) patients were randomized to transtibial single-bundle (SB), anatomic SB, and double-bundle ACL reconstruction. Three-dimensional motion analysis was performed preoperatively and at 1-year follow-up to evaluate tibial rotation and rotational stiffness. Motion data were captured using an eight-camera motion analysis system. Tibial rotation was determined during walking, running, and a pivoting task. Other outcome parameters were KT-1000 knee laxity measurements and the subjective outcome scores KOOS and IKDC. Results Three-dimensional motion analysis demonstrated that the tibial internal rotation and the rotational stiffness did not differ between the ACL reconstruction techniques during walking, running, and pivoting at 1-year follow-up. Objective knee stability and subjective outcome scores did not differ between the reconstruction groups. Conclusion No significant difference in rotational stability walking, running, and pivoting was seen between anatomic and nonanatomic ACL reconstruction techniques at 1-year follow-up. Level of evidence Therapeutic study, Level I.