Long-term Clinical Outcomes After Single- Versus Double-Bundle ACL Reconstruction: A Matched-Pair Analysis From the...

Area of Science:

• Orthopedic surgery
• Sports medicine
• Biomechanical engineering

Background:

• Anterior cruciate ligament reconstruction (ACLR) techniques have evolved towards more anatomic approaches.
• Double-bundle (DB) reconstruction theoretically offers superior rotational control over single-bundle (SB) reconstruction.
• Limited studies compare mid- to long-term outcomes of SB versus DB ACLR.

Purpose of the Study:

• To compare the long-term clinical outcomes of SB and DB ACLR.
• To test the hypothesis that both techniques yield similar clinical results at extended follow-up.

Main Methods:

• A cohort study (Level of evidence, 3) analyzed primary ACLR cases using hamstring autografts.
• Propensity score matching adjusted for age, sex, BMI, meniscal status, and sports participation.
• Kaplan-Meier and Cox proportional hazards models assessed graft survival, laxity, and reoperation rates.

Main Results:

• 396 patients (198 per group) were followed for a mean of 14.7 years.
• Graft rupture occurred in 11.1% of SB and 9.1% of DB patients (P = .52), with no significant difference.
• Reoperation rates and anterior laxity measurements were comparable between SB and DB ACLR groups.

Conclusions:

• SB and DB ACLR techniques demonstrate similar long-term clinical results.
• Both SB and DB ACLR show comparable efficacy in graft survival, reoperation rates, and stability over >14 years.
• Hamstring autograft choice between SB and DB techniques does not significantly impact long-term outcomes.