Purpose
To compare postoperative objective knee stability and clinical outcomes between double-bundle
(DB) anterior cruciate ligament reconstruction (ACLR) and single-bundle (SB) ACLR
combined with lateral extra-articular tenodesis (LET).
Methods
ACL-injured patients with grade 3 pivot-shift who underwent either DB ACLR (DB ACLR
group) or SB ACLR with LET (SB ACLR+LET group) were enrolled. All patients who met
inclusion and exclusion criteria were retrospectively evaluated for knee laxity (the
anterior translation and pivot-shift grade), clinical outcomes using the International
Knee Documentation Committee (IKDC) examination form, Kellgren–Lawrence grade, graft
maturation score on second-look arthroscopy, and revision rates at the last follow-up.
Results
From an initial cohort of 171 consecutive patients over a 3-year period, 95 (56%)
met inclusion and exclusion criteria. The SB ACLR+LET group (n = 47) showed significantly
better results in pivot-shift grade at the last follow-up as compared with the DB
ACLR group (n = 48) (P = .021). In the SB ACLR+LET group, 93.6% (44/47) were grade 0, whereas 72.9% (35/48)
in the DB ACLR group were grade 0. The SB ACLR+LET group (grade A: 42, grade B: 4
and grade C: 1) showed significantly superior results in IKDC objective grade compared
with the DB ACLR group (grade A: 32; grade B: 8; and grade C: 8) (P = .017). However, no statistically significant difference could be shown in anterior
translation, subjective functional IKDC score, or revision rate between the 2 groups.
The mean follow-up duration was 49.7 ± 5.7 months.
Conclusions
SB ACLR + LET demonstrated fewer pivot-shifts (P = .021) and superior IKDC objective grades (P = .017) than a DB ACLR at a mean follow-up of almost 50 months.
Level of Evidence
Level III, retrospective comparative study.
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Article info
Publication history
Published online: November 11, 2020
Accepted:
November 1,
2020
Received:
April 24,
2020
Footnotes
See commentary on page 985
The authors report that they have no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2020 by the Arthroscopy Association of North America
