A randomized clinical study was conducted to compare the outcome between double-bundle and single-bundle anterior cruciate ligament (ACL) reconstructions with 4-strand hamstring tendons (semitendinosus and gracilis.
56 patients with ACL injury in one knee were recruited with 27 allocated to the double bundle ACL reconstruction group and 29 to the single bundle ACL reconstruction group and were analyzed including Lysholm knee scores, Tegner activity scores, Lachman and pivot shift test results, and radiographic stabilities were also compared between the two groups after a minimum of 3 year follow-up.
Clinical outcomes were similar in the two groups at 3 year follow-up (p>0.5). Furthermore, stability results of Lachman test, pivot shift test, and radiological findings at 3 year follow-up failed to reveal any significant inter-group differences (p>0.05). Notchplasty rate was different between two groups: double bundle (25.9%) and single bundle group (58.6%) (p<0.05). In double bundle ACL reconstruction group, there was no extension deficit showing PL bundle rupture but 3 cases (11.1%) of medial joint tightness implying PL bundle tightness.
Double bundle ACL reconstruction does not produce better in clinical outcomes and postoperative stabilities after a minimum of 3 year follow-up. This suggests that only AML fiber reconstruction in ACL injury patients can produce a stable and reliable clinical result. Notchplasty rather than methods of ACL reconstruction may play an more important role in early postoperative rotational stability in double bundle ACL reconstruction.
© 2010 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.