Double-Bundle vs. Single-Bundle Anterior Cruciate Ligament Reconstruction: Prospective, Randomize Clinical Study (SS-08)

Abstract

Sixty-five patients were randomized into either double-bundle (n = 35) or single-bundle (n = 30) ACL reconstruction with hamstring tendons and bioabsorbable screw (Hexalon, Inion Company, Finland) fixation in both group. At the 1-year follow-up, the rotational stability and the early anterior stability were significantly better in the double-bundle group than in the single-bundle group. In addition, none of the patients in double-bundle group had graft failure, while four patients in the single-bundle group had. However, knee scores were equal at the follow-up, and all the results were significantly better at the follow-up than preoperatively, in both groups. The purpose of this prospective, randomize clinical study is to compare the outcomes of anterior cruciate ligament reconstruction when using either double-bundle or single-bundle technique and bioabsorbable interference screw fixation with both techniques. Sixty-five patients were randomized into either double-bundle (n = 35) or single-bundle (n = 30) ACL reconstruction with hamstring tendons and bioabsorbable screw (Hexalon, Inion Company, Finland) fixation in both group. The evaluation methods were clinical examination, KT-1000 arthrometer measurements, radiographic evaluation, as well as International Knee Documentation Committee (IKDC), and Lysholm knee scores. There were no differences between the study groups preoperatively. For the minimum of 1-year follow-up (range, 12 to 19 months), 31 patients of the double-bundle group and 27 patients of the single-bundle group were available (89%). At the follow-up, the rotational stability, as evaluated by pivot shift test, was significantly better in the double-bundle group than in the single-bundle group. Also, the early anterior stability was significantly better with double-bundle technique, although at 1-year follow-up, no significant difference between the groups was found anymore. In addition, none of the patients in double-bundle group had graft failure, while four patients in the single-bundle group had. However, knee scores were equal at the follow-up, and all the results were significantly better at the follow-up than preoperatively, in both groups. Rotational stability and early anterior stability were significantly better with double-bundle technique than with single-bundle technique in ACL reconstruction with hamstring autografts and bioabsorbable screw fixation. However, both fixation techniques improved patients’ performance.