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Anatomic single- versus double-bundle ACL reconstruction: a meta-analysis.

Neel Desai1, Haukur Björnsson, Volker Musahl

  • 1Department of Orthopaedics, Sahlgrenska University Hospital, 431 80, Mölndal, Sweden.

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA
|December 18, 2013
PubMed
Summary
This summary is machine-generated.

Anatomic double-bundle anterior cruciate ligament (ACL) reconstruction offers superior antero-posterior (A-P) laxity restoration compared to single-bundle techniques. However, improvements in rotational laxity and graft rupture rates were not significant.

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Area of Science:

  • Orthopedic surgery
  • Sports medicine
  • Biomechanics

Background:

  • Anterior cruciate ligament (ACL) injuries are common, necessitating surgical reconstruction.
  • Anatomic single-bundle and double-bundle techniques are primary surgical options.
  • Restoring knee stability and function is the main goal of ACL reconstruction.

Purpose of the Study:

  • To compare the efficacy of anatomic double-bundle ACL reconstruction versus single-bundle reconstruction.
  • To evaluate restoration of antero-posterior (A-P) and rotatory knee laxity.
  • To assess the frequency of graft rupture in both surgical techniques.

Main Methods:

  • Systematic electronic literature search of PubMed, EMBASE, and Cochrane Library databases.
  • Inclusion of Level I-II evidence therapeutic trials comparing primary anatomic double- versus single-bundle ACL reconstruction.
  • Extraction of data on knee kinematic outcomes (e.g., pivot-shift, Lachman, KT-1000, navigation-based laxity) and graft failure rates.

Main Results:

  • Fifteen studies (970 patients) met eligibility criteria.
  • Anatomic double-bundle ACL reconstruction showed significantly less anterior laxity (KT-1000) and A-P laxity (navigation).
  • No significant differences were found in pivot-shift, Lachman, anterior drawer tests, rotatory laxity, or graft failure rates.

Conclusions:

  • Anatomic double-bundle ACL reconstruction demonstrates superiority in restoring A-P knee laxity compared to single-bundle techniques.
  • The long-term clinical significance of improved laxity restoration remains to be determined.
  • Further research is needed to ascertain the overall clinical benefits of double-bundle ACL reconstruction.