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. 2025 Dec 22;26(1):1116.
doi: 10.1186/s12891-025-09438-6.

Double-bundle anterior cruciate ligament reconstruction (ACLR) and anterolateral ligament reconstruction with suture tape augmentation offers satisfactory 2-year clinical functional scores between single-bundle ACLR and double-bundle ACLR with more lateral knee tightness

Lei Hsia #  1 , Poyu Chen #  2   3 , Cheng-Pang Yang  2   4 , Chen-Heng Hsu  2   4 , Chieh-An Chuang  5 , Joe Chih-Hao Chiu  6   7   8
Affiliations

Double-bundle anterior cruciate ligament reconstruction (ACLR) and anterolateral ligament reconstruction with suture tape augmentation offers satisfactory 2-year clinical functional scores between single-bundle ACLR and double-bundle ACLR with more lateral knee tightness

Lei Hsia et al. BMC Musculoskelet Disord. .

Abstract

Background: Single-bundle (SB) anterior cruciate ligament reconstruction (ACLR), double-bundle (DB) ACLR, and DB ACLR combined with anterolateral ligament reconstruction (DB ACLR and ALLR) have been developed to address ACL tears. We hypothesized that these three techniques provide satisfactory results for patients with ACL tears, with the DB ACL and ALLR group having more lateral knee discomfort.

Methods: 167 patients were retrospectively divided into three groups: SB ACLR, DB ACLR, and DB ACLR and ALLR. Postoperative evaluations were conducted via telephone interviews and in-person consultations using the Tegner and Lysholm scores.

Results: The mean follow-up time was 27.7 ± 4.4 months in the SB ACLR group, 25.5 ± 3.2 months in the DB ACLR group, and 28.1 ± 3.6 months in the DB ACLR and ALLR group (P = 0.044). For Lysholm score, the DB ACLR and ALLR group (n = 55) was 92.3 ± 7.0, the DB ACLR group (n = 21) was 92.4 ± 6.6, and the SB ACLR group (n = 91) was 92.5 ± 10.2 (P = 0.995). For the Tegner score, the DB ACLR and ALLR group was 4.5 ± 2.2, the DB ACLR group was 5.0 ± 1.6, and the SB ACLR group was 4.4 ± 1.7 (P = 0.378). In the DB ACLR and ALLR group, 10 of the 55 (18.2%) patients exhibited symptoms in the lateral knee.

Conclusions: SB ACLR, DB ACLR, and DB ACLR and ALLR with suture tape augmentation procedures yielded comparable clinical functional scores. While lateral knee symptoms were observed in patients receiving DB ACLR and ALLR with suture tape augmentation, these symptoms did not significantly influence the functional outcome.

Keywords: ACL; ALL; Complications; Double-bundle; Lateral knee tightness; Single-bundle.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: 202100829B0, ethical committee approval; Chang Gung Medical Foundation Institutional Review Board (Chairman of the ethics committee, Tsang-Tang Hsieh, MD). Informed consent was obtained from all subjects involved in the study. Written informed consent has been obtained from the patients to publish this paper. This study was approved by the ethics committee of the Chang Gung Medical Foundation Institutional Review Board (IRB 202100829B0), and informed consent was obtained from all patients. All methods were performed in accordance with the relevant guidelines and regulations. Consent for publication: Not Applicable in the consent to publication section. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Surgical techniques of SB ACLR, DB ACLR and DB ACLR and ALLR. A Single bundle ACLR. B Double bundle ACLR. C DB ACLR and ALLR SB, single bundle; DB, double bundle; ACLR, anterior cruciate ligament reconstruction; ALLR, anterolateral ligament reconstruction; AMB, anteromedial bundle; PLB, posterolateral bundle
Fig. 2
Fig. 2
CONSORT flow diagram for the study
Fig. 3
Fig. 3
Knee ROM at different time points. ROM, range of motion; ALLR group, patients who underwent DB ACLR and ALLR; Non-ALLR group, patients who underwent SB ACLR or DB ACLR; ALLR, anterolateral ligament reconstruction
See this image and copyright information in PMC

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