One-stage bilateral anterior cruciate ligament reconstruction

The ideal treatment for patients presenting with bilateral anterior cruciate ligament (ACL) deficiency remains controversial. The purpose was to evaluate cost and functional results after one-stage bilateral ACL reconstruction using either hamstring or patella tendon autograft.

This prospective comparative study was compared the mid-term outcome of 7 patients (14 knees) who had one-stage bilateral ACL reconstruction with that of a matched group of patients who had unilateral reconstruction (21 patients).

The median length of hospital stay was 4 (3-5) nights for the bilateral group and 2 (1-4) nights for the control group. The duration of rehabilitation process in patients from control group with unilateral ACL reconstruction was one week shorter (9 vs 8 weeks). In the bilateral group, the median Lysholm score was 96 (85-100), and in the control group, the median score was 93 (81-100). The median time to return to full-time work and to full sports was 9 weeks and 7 months for the one-stage group and 8 weeks and 6 months for the unilateral group. Six patients (86%) in the bilateral group and 17 patients (81%) in the control group were still performing at their pre-injury level of activity. National Health Institution saved 2925 EUR when we performed one-stage bilateral reconstruction instead of two-stage ACL reconstruction.

Mid-term clinical results suggested that one-stage bilateral ACL reconstruction using either hamstring or patella tendon autograft is clinically effective. For patients presenting bilateral ACL-deficient knees, one-stage bilateral ACL reconstruction is reproducible, cost effective and does not compromise functional results.

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