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Review
. 2017 Dec 1;29(4):246-255.
doi: 10.5792/ksrr.17.050.

Single-Bundle versus Double-Bundle Posterior Cruciate Ligament Reconstruction: A Meta-Analysis of Randomized Controlled Trials

Dong-Yeong Lee  1 , Young-Jin Park  2
Affiliations
Review

Single-Bundle versus Double-Bundle Posterior Cruciate Ligament Reconstruction: A Meta-Analysis of Randomized Controlled Trials

Dong-Yeong Lee et al. Knee Surg Relat Res. .

Abstract

Purpose: This meta-analysis evaluated the benefits of single-bundle (SB) and double-bundle (DB) surgical techniques for posterior cruciate ligament reconstruction (PCLR) in terms of clinical outcomes.

Methods: Five electronic databases were searched for relevant articles published until September 2016. Clinical outcomes of both techniques were evaluated using Lysholm knee function scores, Tegner activity scores, side-to-side differences, and International Knee Documentation Committee (IKDC) objective grades. The results are presented as a risk ratio (RR) for binary outcomes and a weighted mean difference (WMD) for continuous outcomes with a 95% confidence interval (CI).

Results: Four randomized controlled trials (RCTs) were included. There were no significant differences in the Lysholm knee function scores (WMD=1.63; 95% CI, 0.00 to 3.27; I2=0%), Tegner activity scores (WMD=0.17; 95% CI, -0.08 to 0.43; I2=20%), side-to-side differences (WMD=-0.97; 95% CI, -2.41 to 0.47; I2=78%), and IKDC objective grades (RR=1.18; 95% CI, 1.00 to 1.39; I2=0%) at the final follow-up.

Conclusions: The present study demonstrates that both SB and DB techniques for PCLR are comparable in terms of restoration of knee stability and improvement of knee function. However, it is still unclear which technique yields better clinical outcomes. To verify and further corroborate our results, more larger-scale, high-quality RCTs are encouraged.

Keywords: Arthroscopy; Knee; Meta-analysis; Posterior cruciate ligament; Reconstruction.

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Conflict of interest statement

Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
PRISMA (Preferred Reporting Items of Systematic Reviews and Meta-Analyses) flow diagram.
Fig. 2
Fig. 2
Forest plot of Lysholm knee function scores (points) in both techniques. DB: double-bundle, SB: single-bundle, SD: standard deviation, CI: confidence interval.
Fig. 3
Fig. 3
Forest plot of Tegner activity scores (points) in both techniques. DB: double-bundle, SB: single-bundle, SD: standard deviation, CI: confidence interval.
Fig. 4
Fig. 4
Forest plot of side-to-side differences (mm) in both techniques. DB: double-bundle, SB: single-bundle, SD: standard deviation, CI: confidence interval.
Fig. 5
Fig. 5
Forest plot of International Knee Documentation Committee objective grades in both techniques. DB: double-bundle, SB: single-bundle, SD: standard deviation, CI: confidence interval.
See this image and copyright information in PMC

References

    1. Fanelli GC, Edson CJ. Posterior cruciate ligament injuries in trauma patients: part II. Arthroscopy. 1995;11:526–9. doi: 10.1016/0749-8063(95)90127-2. - DOI - PubMed
    1. Amis AA, Gupte CM, Bull AM, Edwards A. Anatomy of the posterior cruciate ligament and the meniscofemoral ligaments. Knee Surg Sports Traumatol Arthrosc. 2006;14:257–63. doi: 10.1007/s00167-005-0686-x. - DOI - PubMed
    1. Mauro CS, Sekiya JK, Stabile KJ, Haemmerle MJ, Harner CD. Double-bundle PCL and posterolateral corner reconstruction components are codominant. Clin Orthop Relat Res. 2008;466:2247–54. doi: 10.1007/s11999-008-0319-z. - DOI - PMC - PubMed
    1. Baker CL, Jr, Norwood LA, Hughston JC. Acute combined posterior cruciate and posterolateral instability of the knee. Am J Sports Med. 1984;12:204–8. doi: 10.1177/036354658401200307. - DOI - PubMed
    1. Covey DC, Sapega AA, Sherman GM. Testing for isometry during reconstruction of the posterior cruciate ligament: anatomic and biomechanical considerations. Am J Sports Med. 1996;24:740–6. doi: 10.1177/036354659602400607. - DOI - PubMed

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