A prospective randomized study comparing double- and single-bundle techniques for anterior cruciate ligament...

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomechanical Research

Background:

• Anterior cruciate ligament (ACL) ruptures are common injuries, often requiring surgical reconstruction.
• Hamstring tendon autografts are frequently used for ACL reconstruction.
• Comparing double-bundle and single-bundle techniques is crucial for optimizing patient outcomes.

Purpose of the Study:

• To compare the clinical outcomes of arthroscopic ACL reconstruction using double-bundle versus single-bundle hamstring tendon autografts.
• To evaluate the effectiveness of each technique on the pivot-shift test, a key indicator of knee stability.

Main Methods:

• A randomized controlled trial (Level of evidence, 1) involving 103 patients with unilateral ACL rupture.
• Patients underwent either double-bundle (53 patients) or single-bundle (50 patients) anatomic ACL reconstruction.
• Outcomes were assessed preoperatively and at a median of 26 months post-surgery by a blinded observer, with the pivot-shift test as the primary variable.

Main Results:

• No significant differences were found between the double-bundle and single-bundle groups in pivot-shift test results at 2-year follow-up.
• Other assessed outcomes, including KT-1000 laxity, Lachman test, range of motion, Lysholm score, Tegner activity scale, KOOS, and hop tests, also showed no significant differences.
• Both surgical techniques demonstrated significant improvements in most clinical assessments compared to preoperative values.

Conclusions:

• The double-bundle ACL reconstruction technique did not provide a statistically significant advantage over the single-bundle technique regarding the pivot-shift test or other subjective/objective outcomes.
• At 2 years post-surgery, both techniques yielded comparable results in an unselected patient population.
• Further research may explore long-term differences or specific patient subgroups.