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Updated: Apr 18, 2026

Author Spotlight: Implementing the Enhanced Recovery After Surgery Concept in Rehabilitation Following Anterior Cruciate Ligament Reconstruction
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Balance ability and proprioception after single-bundle, single-bundle augmentation, and double-bundle ACL

Yubao Ma1, Masataka Deie1, Daisuke Iwaki2

  • 1Department of Musculoskeletal Functional Research and Regeneration, Graduate School of Biomedicine and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.

Thescientificworldjournal
|January 24, 2015
PubMed
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Double-bundle (DB) and single-bundle augmentation (SBA) anterior cruciate ligament (ACL) reconstructions improve balance and proprioception compared to single-bundle (SB) reconstructions. SBA and DB also offer superior knee stability.

Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Rehabilitation Science

Background:

  • Anterior cruciate ligament (ACL) reconstruction aims to restore knee function.
  • Different surgical techniques, including single-bundle (SB), single-bundle augmentation (SBA), and double-bundle (DB) reconstructions, are employed.
  • The impact of these techniques on functional recovery, particularly balance and proprioception, requires further elucidation.

Purpose of the Study:

  • To compare the effects of SB, SBA, and DB ACL reconstructions on balance ability and proprioceptive function.
  • To evaluate the influence of these reconstruction methods on knee stability and lower extremity muscle strength.

Main Methods:

  • A cohort of 67 patients undergoing ACL reconstruction (SB, SBA, or DB) with hamstring tendons was followed for 1 year.

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  • Balance was assessed using body sway, and proprioception using the threshold to detect passive motion (TTDPM) test.
  • Anterior-posterior tibial stability and muscle strength were measured pre- and post-surgery.

    • Main Results:

    • DB reconstruction showed significantly better balance and proprioception than SB reconstruction at 6 and 12 months.
    • SBA and DB reconstructions resulted in superior knee stability compared to SB reconstruction.
    • No significant differences in quadriceps or hamstring strength were observed among the three techniques.

    Conclusions:

    • SBA and DB ACL reconstructions lead to superior joint stability, proprioceptive function, and balance ability compared to SB reconstruction.
    • These findings suggest that SBA and DB techniques may offer improved functional outcomes for patients following ACL reconstruction.