ACL (Anterior Cruciate ligament) tear has become one of the most common sports related injuries and its treatment has evolved tremendously. Anatomical restoration of footprint remains imperative. The author wishes to study the size(area) of Tibial ACL foot print in Indian population and efficacy of single versus a double bundle reconstruction in restoring anatomical landmarks.

Material & Methods:

The randomized prospective study included 100 male patients with diagnosed isolated ACL tear divided into two groups of 50 each. Group A & Group B patients underwent a double & single bundle (SB) reconstruction irrespective of their anatomical foot–prints using autologous hamstring graft. All patients were followed up at 12 months for functional & radiological assessment in restoring the anatomical footprint. Measurements were done by two authors independently using the GE Optima™ MR450w MR scanner and Horos 3.0.0 RC 2 software.

Results:

The patients of group A (DB) had a closer restoration of anatomical foot–print in comparison to patients of Group B (SB). Mean ACL tibial footprint area in normal limb were 153.9 mm² in the cohort. The mean width and mid–sagittal depth of the foot–print were 9.5± 1.6mm & 16.2±2.0mm respectively on the unaffected side. Patients in Group A & Group B had a mean width & mid–sagittal depth of 8.9±1.1mm; 16.1 ± 1.7 mm & 7.9±1.3 & 15.6±1.3 mm respectively.

The mean area of the tibial footprint that a double bundle reconstruction could restore was 143.29 mm² and in the cases with single bundle reconstruction this was 123.24 mm². The area restored by a double bundle reconstruction was closer to the original anatomical Tibial footprint in comparison to a single bundle reconstruction when compared from the normal limb in the cohort.

Conclusion:

Double bundle technique replicates the footprint anatomy more closely in comparison to a single bundle reconstruction. Anatomical replication remains imperative in restoration of the normal joint kinematics and so individualized treatment should be sought after identifying the morphometry of the foot–print.