Cochrane in CORR (®): Double-bundle Versus Single-bundle Reconstruction for Anterior Cruciate Ligament Rupture in Adults (Review).

Abstract

A nterior cruciate ligament (ACL) injuries most commonly occur in young, active patients, with an annual incidence of more than 200,000 in the United States alone [8, 11, 13]. Approximately 65% of these patients undergo ACL reconstruction, but there is ongoing debate about the most appropriate techniques [6]. Earlier studies have explored the importance of tunnel placement, graft selection, graft fixation, and rehabilitation protocols, but recent attention has focused on the role of doublebundle reconstruction [2]. The native ACL consists of two discrete anteromedial and posterolateral bundles, which respectively account for translational and rotational stability [9, 10, 13]. Double-bundle ACL reconstruction involves reconstructing each of these bundles separately and is purported to more closely restore native knee anatomy and biomechanics. However, double-bundle ACL reconstructions are more technically demanding than conventional singlebundle techniques, they require greater operative time, and are more difficult to revise when they fail [10]. Multiple randomized controlled trials have been recently performed to evaluate whether double-bundle ACL reconstruction is superior to single-bundle