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Related Experiment Video

Updated: Jun 23, 2026

Author Spotlight: Double Posteromedial Approach for Treating Posterior Cruciate Ligament Cysts

Author Spotlight: Double Posteromedial Approach for Treating Posterior Cruciate Ligament Cysts

Published on: October 20, 2023

Re-Revision ACL Reconstruction: A Double-Bundle Technique Video.

Camden Bohn^1,2, Catherine Hand^1,3, Joshua Chang^1,2

¹Midwest Orthopaedics at RUSH, Chicago, Illinois, USA.

Video Journal of Sports Medicine

|August 14, 2025

Summary

Revision anterior cruciate ligament (ACL) reconstruction using the double-bundle technique offers anatomic benefits and enhanced stability. This method aims to replicate native ACL anatomy for improved outcomes in complex cases.

Keywords:

anterior cruciate ligament reconstruction double-bundle technique surgical outcomes surgical technique video

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Last Updated: Jun 23, 2026

Author Spotlight: Double Posteromedial Approach for Treating Posterior Cruciate Ligament Cysts

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Novel Triple-Loop Technique for Suturing TFCC Injuries without Transosseous Tunnel

Published on: May 23, 2025

Area of Science:

Orthopedic Surgery
Sports Medicine
Knee Biomechanics

Background:

Anterior cruciate ligament (ACL) tears are common knee injuries requiring surgical intervention.
Revision ACL reconstruction often employs single-bundle techniques, but the native ACL has two bundles.
Double-bundle ACL reconstruction aims to replicate native anatomy more accurately.

Purpose of the Study:

To demonstrate a reproducible arthroscopic surgical technique for double-bundle ACL reconstruction.
To highlight the benefits of double-bundle ACLR in revision settings.

Main Methods:

Arthroscopic delineation of the ACL footprint.
Sequential drilling of anteromedial and posterolateral femoral sockets, maintaining a bone bridge.
Creation of two tibial tunnels under direct visualization.
Allograft preparation (tibialis anterior and bone-patellar tendon-bone).
Sequential graft passage and fixation using interference screws and anchors.

Main Results:

A clinical trial showed an 85% survival rate from needing a second revision ACLR with allograft use over 10.7 years.
Meta-analysis indicated double-bundle superior to single-bundle in International Knee Documentation Committee subjective evaluations (P < .05).
Another meta-analysis found no significant difference in clinical outcomes between single-bundle and double-bundle ACLR.

Conclusions:

Double-bundle ACL reconstruction provides significant anatomic and biomechanical advantages.
It offers increased graft volume and stability, particularly beneficial in re-revision cases with concurrent lateral extra-articular tenodesis and normal posterior tibial slope.