Double-Bundle and Single-Bundle ACL Reconstruction Techniques Did Not Differ in Terms of Clinical Outcomes at 2 or 5 Years.

Abstract

Sasaki S, Tsuda E, Hiraga Y, Yamamoto Y, Maeda S, Sasaki E, Ishibashi Y. Prospective randomized study of objective and subjective clinical results between double-bundle and single-bundle anterior cruciate ligament reconstruction. Am J Sports Med. 2016 Apr;44(4):855-64. ### Question: What is the relative effectiveness of double-bundle anterior cruciate ligament (ACL) reconstruction with hamstring tendon graft (DB-HT) and rectangular-tunnel single-bundle ACL reconstruction with patellar tendon graft (RTSB-PT) at 2 years? ### Design: Randomized (unclear allocation concealment), unblinded, controlled trial with a mean of 3.2 years of follow-up. ### Setting: 1 clinical center at Hirosaki University, Hirosaki, Japan. ### Patients: 150 patients (mean age, 26 years; 58% women) who needed ACL reconstruction. Exclusion criteria were skeletal immaturity with an open physis of the femur or tibia, bilateral ACL injury or multiple knee ligament injury, revision ACL surgery, knee osteoarthritis, knee surgery with high tibial osteotomy or medial patellofemoral ligament reconstruction, or failure to complete the study questionnaire. 91% of patients completed follow-up. ### Intervention: DB-HT (n = 76) or RTSB-PT (n = 74). For the DB-HT technique, the semitendinosus tendon was used in 94% of patients. The graft was split and used for the anteromedial bundle (AMB) and posterolateral bundle (PLB). The femoral and tibial tunnel positions were created according to accepted anatomical guidelines. The femoral tunnel for the AMB was made with use of either a transtibial or outside-in technique. Fixation on the femur and tibia was done with a cortical-button suspension technique. For the RTSB-PT technique, the bone blocks of the bone-patellar tendon-bone grafts …