ACL reconstruction with single tibial tunnel: single versus double bundle.

Area of Science:

• Orthopedic surgery
• Sports medicine
• Biomechanics

Background:

• Anterior cruciate ligament (ACL) rupture is a common knee injury.
• Double-bundle (DB) ACL reconstruction aims to replicate native ACL anatomy and function more closely than single-bundle (SB) techniques.
• Limited comparative data exists for DB techniques with a single tibial tunnel (DB-3T) versus SB reconstruction.

Purpose of the Study:

• To compare the clinical outcomes of DB-3T ACL reconstruction with SB ACL reconstruction.
• To evaluate rotational stability, joint translation, hop performance, and subjective knee function.

Main Methods:

• Prospective study of patients undergoing DB-3T ACL reconstruction (hamstring tendons).
• Control group of nonconcurrent patients treated with SB ACL reconstruction.
• 2-year follow-up including anterior/posterior translation (APT) assessment, pivot-shift test, one-leg hop test, and International Knee Documentation Committee (IKDC) subjective evaluation.

Main Results:

• No significant difference in anterior/posterior translation (APT) between groups.
• Significant improvements in the DB-3T group for rotational instability (pivot-shift test).
• Significant improvements in the DB-3T group for one-leg hop capacity and IKDC subjective scores.

Conclusions:

• DB-3T ACL reconstruction using hamstring tendons offers superior rotational stability and functional outcomes compared to SB reconstruction at 2-year follow-up.
• DB-3T technique provides better clinical results, enhancing patient-reported function and stability.