Abstract
BackgroundPosterior Cruciate Ligament (PCL) ruptures are common sports injuries. One of the key controversies in PCL reconstruction is whether double-bundle reconstruction provides biomechanical and clinical outcomes superior to single-bundle reconstruction.MethodsWe performed a comprehensive search in multiple databases to evaluate the advantages of single-bundle or double bundle reconstructions in anteroposterior stability, graft tension, rotational stability, and functional outcome.ResultsBiomechanical comparisons evaluating anteroposterior stability described either no difference or increased stability in double-bundle reconstructions. Comparing these results is complicated by different graft choices, tensioning techniques, and tunnel positions. Biomechanical studies of graft tension demonstrated conflicting results regarding the optimal reconstruction technique. Seven retrospective clinical studies of single- and double-bundle reconstructions with methodological limitations reported no difference in clinical outcome.ConclusionsThe superiority of single-bundle or double-bundle posterior cruciate ligament reconstruction remains uncertain.
Highlights
As the primary restraint to posterior translation in the uninjured knee [1, 2], the posterior cruciate ligament (PCL), which largely consists of the anterolateral (AL) and posteromedial (PM) bundles, is the strongest ligament in the knee joint
There is some controversy over the single bundle (SB) versus double bundle (DB) Posterior Cruciate Ligament (PCL) reconstruction methods [13]
This systematic review found that double-bundle reconstruction was significantly superior to single-bundle in biomechanical studies and clinical outcomes showed no significant differences between the two PCL reconstructions
Summary
One of the key controversies in PCL reconstruction is whether double-bundle reconstruction provides biomechanical and clinical outcomes superior to single-bundle reconstruction. Operative indications for these injuries remain controversial, there remains a strong interest in the literature regarding methods of reconstruction [10,11,12]. Both concerns for premature arthritic change and persistent instability as well as in vitro studies showing restoration of knee biomechanics motivated attempts at surgical reconstruction of the PCL. Other studies have shown that the SB technique is effective at reconstructing the AL bundle [18,19,20], making it difficult to distinguish the advantages of either technique
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