Clinical outcomes following anatomic double-bundle ACL reconstruction in skeletally mature adolescent patients:...

The present study was aimed to compare the clinical outcomes following double-bundle (DB) ACL reconstruction (ACLR) with the outcomes following single-bundle (SB) ACLR in skeletally mature teenagers.

A total of 113 skeletally mature teenagers with unilateral ACL injury, who underwent primary ACLR using hamstring autograft with minimum 2 years follow-up, were included. This included 82 DB ACLR (median 16.0 [interquartile range (IQR), 2.0] year-old, male/female: 21/61) and 31 SB ACLR (17.0 [2.0] year-old, male/female: 6/25). At the final follow-up (3.6 [1.9] years), IKDC Subjective Knee Form (IKDC-SKF), Tegner activity scale, the side-to-side difference (SSD) in anterior tibial translation using KT arthrometer were obtained. The rate of residual pivot-shift test, graft rupture rate and contralateral ACL injury rate were also assessed.

The rate of residual pivot-shift test was significantly lower in DB group than SB group (12.0 % vs 33.3 %, P = 0.02). Postoperative Tegner activity scale was significantly greater in DB group (7 [2]) than SB group (4 [4], P = 0.002). No significant differences were observed between two groups in IKDC-SKF (96.6 [10.0] in DB group, 97.7 [9.0] in SB group) and SSD in anterior tibial translation (1.5 [2.0] mm in DB group, 2.0 [2.0] mm in SB group). Graft rupture occurred in seven patients in DB group (8.5 %), and one patient in SB group (3.3 %). Contralateral ACL injury occurred in four patients in DB group (4.9 %), and two patients in SB group (6.5 %). No significant differences were observed between two groups in graft rupture and the contralateral ACL injury rates.

Clinical outcomes following DB ACLR were similar to SB ACLR, but the pivot-shift phenomenon appeared to be better controlled in DB ACLR than SB ACLR. Thus, to better restore rotatory knee stability, DB ACLR may be recommended in the skeletally mature teenagers.

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