Comparison of anatomic ACL reconstruction between selective bundle reconstruction and double-bundle reconstruction

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomedical Engineering

Background:

• Anterior cruciate ligament (ACL) reconstruction techniques aim to restore knee stability.
• The role of preserving native ligament remnants in ACL reconstruction is debated.
• Selective bundle versus double-bundle reconstruction strategies have different surgical approaches.

Purpose of the Study:

• To compare clinical and radiologic outcomes of selective bundle ACL reconstruction with preserved remnants versus double-bundle ACL reconstruction with totally sacrificed remnants.
• To evaluate the efficacy of selective bundle ACL reconstruction as an alternative technique.

Main Methods:

• Retrospective comparative study of 16 patients (selective bundle) and 30 patients (double-bundle) ACL reconstruction.
• Clinical outcomes assessed using Lysholm, Tegner, and IKDC scores.
• Stability evaluated via Lachman, pivot shift, and anterior drawer tests.
• Radiologic assessment included 3D CT for femoral tunnel positioning and MRI for graft signal intensity.

Main Results:

• No significant differences were found in functional scores (Lysholm, Tegner, IKDC) between the groups.
• No significant differences in knee stability tests (Lachman, pivot shift, anterior drawer) were observed.
• Femoral tunnel positioning and graft signal intensity showed no statistically significant differences between selective and double-bundle reconstructions.

Conclusions:

• Selective bundle ACL reconstruction with preserved ligament remnants yields comparable clinical and radiologic results to double-bundle ACL reconstruction.
• Selective bundle ACL reconstruction is a suitable alternative to double-bundle reconstruction when viable ligamentous tissue is available.