Single-Bundle Versus Double-Bundle Anterior Cruciate Ligament Reconstruction Assessment with Vertical Jump Test. Are the Results Really “Superior”? When Perception Does Become Reality!

Abstract

I have read the article by Ventura et al., “Single-Bundle Versus Double-Bundle Anterior Cruciate Ligament Reconstruction: Assessment with Vertical Jump Test,”1Ventura A. Iori S. Legnani C. Terzaghi C. Borgo E. Albisetti W. Single-bundle versus double-bundle anterior cruciate ligament reconstruction: Assessment with vertical jump test.Arthroscopy. 2013; 20: 1201-1210Abstract Full Text Full Text PDF Scopus (18) Google Scholar with great interest. The information helps those of us involved in trying to understand the benefits of the double- versus single-bundle anterior cruciate ligament (ACL) repair. My concerns regard the conclusions in the abstract that precedes the article. The authors specifically state in their conclusions, “DB ACL reconstruction has been proven to be superior to the SB technique with regard to knee stability and vertical jump performance.” I have several qualms about this statement:1.The term superior implies a better quality; yet stability and vertical jump cannot be quantified by “quality.”2.There is no statement in the “Conclusions” section that describes the counter movement jump as being nonsignificant in terms of comparison of the 2 groups.3.Knee stability showed no significant difference in comparing anterior draw and Lachman tests. The only significance of importance was the instrumented testing, which showed a 2-mm laxity in single-bundle repairs and 1.6-mm laxity in double-bundle repairs. This belies the definition of the term superior.4.The authors have not noted in their conclusions that there was no difference in pain, subjective evaluation, Visual Analogue Scale score, range of motion, Lachman testing, or counter movement jump. My concern is that the abstract that is presented before an article is the only part that is presented in Medline or a database search. This abstract has cherry-picked 2 aspects of a well-performed study to make it appear that the double-bundle ACL reconstruction is superior to the single-bundle ACL reconstruction. This clearly is not the case. It would be prudent for the editors to note that such abstracts are all that many readers may be able to access through typical data bank searches. Including slightly more information in the abstract would result in a more enlightened audience. Again, the authors have presented a well-researched article. It is not the article, it is how it was edited and presented. The conclusions in the abstract give a perception that is not reality. Single-Bundle Versus Double-Bundle Anterior Cruciate Ligament Reconstruction: Assessment With Vertical Jump TestArthroscopyVol. 29Issue 7PreviewThe study was designed to compare the clinical results of traditional single-bundle (SB) anterior cruciate ligament (ACL) reconstruction with those of double-bundle (DB) ACL reconstruction. Full-Text PDF Authors' ReplyArthroscopyVol. 29Issue 11PreviewWe thank Dr. Siegel for his interest in our recent contribution to Arthroscopy, “Single-bundle Versus Double-Bundle Anterior Cruciate Ligament Reconstruction: Assessment with Vertical Jump Test.” However, we do not agree with his statements and we firmly refute the expression “…has cherry picked two aspects…” since in the abstract we reported correctly, in a concise way, the main findings of our study. Full-Text PDF