Double-bundle versus single-bundle ACL reconstruction using the horizontal femoral position: a prospective,...

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomechanical Engineering

Background:

• Anterior cruciate ligament (ACL) injuries are common, often requiring surgical reconstruction.
• The choice between single-bundle (SB) and double-bundle (DB) ACL reconstruction techniques impacts knee stability.
• Optimizing femoral tunnel placement is crucial for successful ACL reconstruction outcomes.

Purpose of the Study:

• To compare the efficacy of double-bundle (DB) versus single-bundle (SB) ACL reconstruction.
• To evaluate the impact of femoral tunnel placement (2 or 10 o'clock) on knee stability.
• To assess functional outcomes using the International Knee Documentation Committee (IKDC) criteria.

Main Methods:

• A randomized prospective study involving 40 patients undergoing ACL reconstruction.
• Patients were allocated to either the DB group (20) or SB group (20).
• Utilized semitendinosus and gracilis autografts; assessed anteroposterior (AP) laxity via standardized radiology and clinical examination (pivot-shift, manual laxity).

Main Results:

• No significant preoperative differences were observed between the SB and DB groups.
• Both SB and DB techniques demonstrated significant improvements in preoperative versus postoperative evaluations.
• No significant differences in functional scores (IKDC) or laxity were found between the SB and DB groups at 2-year follow-up.

Conclusions:

• Neither the SB nor DB ACL reconstruction technique showed superiority in terms of knee stability or functional outcomes.
• Femoral tunnel placement at 2 or 10 o'clock did not yield significant differences between SB and DB techniques.
• Both surgical approaches significantly enhance knee stability and function post-reconstruction.