Abstract
BackgroundBoth single-bundle (SB) and double-bundle (DB) techniques were widely used in anterior cruciate ligament (ACL) reconstruction recently. Nevertheless, up to now, no consensus has been reached on whether the DB technique was superior to the SB technique. Moreover, follow-up of the included studies in the published meta-analyses is mostly short term. Our study aims to compare the mid- to long-term outcome of SB and DB ACL reconstruction concerning knee stability, clinical function, graft failure rate, and osteoarthritis (OA) changes.MethodsThis study followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The PubMed, Embase, and the Cochrane Library were searched from inception to October 2017. The study included only a randomized controlled trial (RCT) that compared SB and DB ACL reconstruction and that had a minimum of 5-year follow-up. The Cochrane Collaboration’s risk of bias tool was used to assess the risk of bias for all included studies. Stata/SE 12.0 was used to perform a meta-analysis of the clinical outcome.ResultsFive RCTs were included, with a total of 294 patients: 150 patients and 144 patients in the DB group and the SB group, respectively. Assessing knee stability, there was no statistical difference in side-to-side difference and negative rate of the pivot-shift test. Considering functional outcome, no significant difference was found in proportion with International Knee Documentation Committee (IKDC) grade A, IKDC score, Lysholm scores, and Tegner scores. As for graft failure rate and OA changes, no significant difference was found between the DB group and the SB group.ConclusionThe DB technique was not superior to the SB technique in autologous ACL reconstruction regarding knee stability, clinical function, graft failure rate, and OA changes with a mid- to long-term follow-up.
Highlights
Both single-bundle (SB) and double-bundle (DB) techniques were widely used in anterior cruciate ligament (ACL) reconstruction recently
Several biomechanical studies [10–14] reported that the DB technique could rebuild both the anteromedial bundle (AMB) and the posterolateral bundle (PLB) and might reproduce knee stability and kinematics closer to the native knee than the SB technique in ACL reconstruction
Several researchers [6, 22, 24–28] found that both knee stability and clinical functions had no significant difference between the two techniques in ACL reconstruction
Summary
Both single-bundle (SB) and double-bundle (DB) techniques were widely used in anterior cruciate ligament (ACL) reconstruction recently. ACL reconstruction is widely used to restore knee laxity, reestablish biomechanical homeostasis, and prevent the long-term joint degeneration [3–5]. In recent years, both single-bundle (SB) and double-bundle (DB) techniques were commonly used in ACL reconstruction [6, 7]. It is well known that the ACL may be divided into two functional bundles, the anteromedial bundle (AMB) and the posterolateral bundle (PLB) [5, 8] These two grafts cross each other inside the joint, acting separately at different knee angles. Several biomechanical studies [10–14] reported that the DB technique could rebuild both the AMB and the PLB and might reproduce knee stability and kinematics closer to the native knee than the SB technique in ACL reconstruction. Given the diverse results of previous studies, it is imperative to pool the data to compare the DB and SB techniques and provide a reference for ACL reconstruction
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
