No difference in revision rates between single- and double-bundle anterior cruciate ligament reconstruction: a comparative study of 16,791 patients from the Swedish national knee ligament register

Abstract

Purpose: The purpose was to compare revision rates and patient-reported outcomes between single- and double-bundle anterior cruciate ligament (ACL) reconstructions.

Methods: All patients from the Swedish National Knee Ligament Register from 2005 through 2011 who underwent primary ACL reconstruction with hamstring autografts were included. Patients with concomitant injuries, except meniscal and chondral injuries, were excluded. By December 31, 2011, 16,791 primary isolated ACL reconstructions had been registered, of which 16,281 were single-bundle and 510 were double-bundle. Cumulative revision rates were estimated using Kaplan-Meier analysis. The Knee injury and Osteoarthritis Outcome Score (KOOS) and EQ-5D were calculated at 1- and 2-year follow-ups.

Results: The revision rate showed no statistically significant differences between the groups (P = .30). Over the 7-year observation period, 347 single-bundle (2.1%) and 8 double-bundle (1.6%) ACL reconstructions were revised. No significant differences in the KOOS or EQ-5D were found between the groups postoperatively. In addition, there were no differences in postoperative improvements in the KOOS or EQ-5D at 1- and 2-year follow-ups.

Conclusions: Revision rates after single- and double-bundle ACL reconstructions were low. No differences were found in revision rates, KOOS, and EQ-5D between the 2 techniques.

Level of evidence: Level III, retrospective comparative study.