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Randomized Controlled Trial
. 2012 Mar;470(3):824-34.
doi: 10.1007/s11999-011-1940-9.

Single- versus double-bundle ACL reconstruction: is there any difference in stability and function at 3-year followup?

Alberto Gobbi  1 , Vivek Mahajan, Georgios Karnatzikos, Norimasa Nakamura
Affiliations
Randomized Controlled Trial

Single- versus double-bundle ACL reconstruction: is there any difference in stability and function at 3-year followup?

Alberto Gobbi et al. Clin Orthop Relat Res. 2012 Mar.

Abstract

Background: Despite a number of studies comparing postoperative stability and function after anatomic double-bundle and single-bundle anterior cruciate ligament reconstruction (ACLR), it remains unclear whether double-bundle reconstruction improves stability or function.

Questions/purposes: We therefore asked whether patients having single- and double-bundle ACLR using semitendinosus (ST) alone differed with regard to (1) postoperative stability; (2) ROM; and (3) five functional scores.

Methods: We prospectively followed 60 patients with an isolated anterior cruciate ligament (ACL) injury. Thirty patients underwent single-bundle and 30 patients underwent double-bundle ACL reconstruction. Clinically we assessed stability and range of motion (ROM); anteroposterior stability was assessed by Rolimeter and rotational stability by a pivot shift test. Function was assessed by IKDC, Noyes, Lysholm, Marx, and Tegner activity scales. The minimum followup was 36 months (mean, 46.2 months; range, 36-60 months).

Results: Residual anteroposterior laxity at 3 years postoperatively was similar in both groups: 1.4 ± 0.3 mm versus 1.4 ± 0.2 mm, respectively. We observed no difference in the pivot shift test. ROM was similar in both groups, although double-bundle patients required more physical therapy sessions to gain full ROM. IKDC, Noyes, Lysholm, Marx, and Tegner scores were similar at final followup.

Conclusion: Double-bundle reconstruction of the ACL did not improve function or stability compared with single-bundle reconstruction.

Level of evidence: Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Figures

Fig. 1A–B
Fig. 1A–B
Graft preparation for single-bundle (A) and double-bundle (B) ACL reconstruction using semitendinosus (ST) tendon. AM = anteromedial; PL = posterolateral.
Fig. 2A–B
Fig. 2A–B
Postoperative anteroposterior radiographs after the ACL reconstruction demonstrating tunnels location in (A) the single-bundle technique and (B) double-bundle technique. AM = anteromedial tunnel; PL = posterolateral tunnel.
Fig. 3A–B
Fig. 3A–B
Box plots showing improvement in Tegner score (A) and laxity (B) from preoperative evaluation to 6-, 12-, and 36-month followup. We observed no difference in improvement between the two groups at the prospective followup; the Tegner score at last followup approached that of the preinjury value in the single-bundle group.
Fig. 4A–B
Fig. 4A–B
Scatterplot showing a correlation between preoperative psychovitality and Tegner score at last followup for all the patients (A) as well as for each group separately (B).
See this image and copyright information in PMC

References

    1. Adachi N, Ochi M, Uchio Y, Iwasa J, Kuriwaka M, Ito Y. Reconstruction of the anterior cruciate ligament: single- versus double-bundle multistranded hamstring tendons. J Bone Joint Surg Br. 2004;86:515–520. - PubMed
    1. Amis AA, Dawkins GP. Functional anatomy of the anterior cruciate ligament. Fibre bundle actions related to ligament replacements and injuries. J Bone Joint Surg Br. 1991;73:260–267. - PubMed
    1. Balasch H, Schiller M, Friebel H, Hoffmann F. Evaluation of anterior knee joint instability with the Rolimeter. A test in comparison with manual assessment and measuring with the KT-1000 arthrometer. Knee Surg Sports Traumatol Arthrosc. 1999;7:204–208. doi: 10.1007/s001670050149. - DOI - PubMed
    1. Calvisi V, Lupparelli S, Rinonapoli G, Padua R. Single-bundle versus double bundle arthroscopic reconstruction of the anterior cruciate ligament: what does the available evidence suggest? J Orthop Traumatol. 2007;8:95–100. doi: 10.1007/s10195-007-0171-z. - DOI - PubMed
    1. Chen CH, Chuang TY, Wang KC, Chen WJ, Shih CH. Arthroscopic anterior cruciate ligament reconstruction with quadriceps tendon autograft: clinical outcome in 4–7 years. Knee Surg Sports Traumatol Arthrosc. 2006;14:1077–1085. doi: 10.1007/s00167-006-0111-0. - DOI - PubMed

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