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PurposeTo perform a systematic review and compare the functional and objective outcomes after single‐bundle (SB) vs. double‐bundle (DB) posterior cruciate ligament reconstruction (PCLR). Where possible to pool outcomes and arrive at summary estimates of treatment effect for DB PCLR vs. SB PCLR via an embedded meta‐analysis. MethodsA comprehensive PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) literature search identified 13 eligible studies evaluating clinical outcomes of both techniques for PCLR. Clinical outcome measures included in the meta‐analysis were functional outcomes (Lysholm Score, Tegner Activity Scale) and objective measurements of posterior laxity of the operated knee (arthrometer and stress radiographs). ResultsThe meta‐analysis included 603 patients. Three hundred and fifteen patients were treated with SB and two hundred and eighty‐eight patients with DB PCLR. There were no significant differences between SB and DB PCLR in postoperative functional Lysholm Scores (CI [− 0.18, 0.17]), Tegner Activity Scales (CI [− 0.32, 0.12]) and IKDC objective grades (CI [− 0.13, 1.17]). Regarding posterior stability using KT‐1000 and Kneelax III arthrometer measurements, there were no differences between the SB and DB group. However, double‐bundle reconstruction provided better objective outcome of measurement of posterior laxity (CI [0.02, 0.46]) when measured with Telos stress radiography. ConclusionA systematic review was conducted to identify current best evidence pertaining to DB and SB PCLR. An embedded meta‐analysis arrived at similar summary estimates of treatment effect for motion, stability and overall function for both techniques. There is no demonstrable clinically relevant difference between techniques based on the currently available evidence. Level of evidenceIII.

Background We provide a meta-analysis for clinicians and researchers regarding the psychometric properties of the WOMET as a patient-reported outcome measure (PROM) for patients with meniscal pathologies. Methods A comprehensive literature search identified 6 eligible papers evaluating WOMET measurement properties in patients with different meniscal injuries and meniscal treatments following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The quality of the included studies was evaluated using the four-point Consensus-based Standard for the selection of health Measurement Instruments (COSMIN) Checklist for good measurement properties. The checklist was specifically developed for studies on health-related PROMs. Results Our meta-analysis suggests that the WOMET can be used to evaluate patients with different meniscal injuries and meniscal treatments, especially acute or chronic meniscal injuries and traumatic or degenerative meniscal injuries treated operatively or conservatively. The WOMET shows satisfactory internal consistency, test-retest reliability, and construct validity. Due to limitations in both sample sizes and methodologies of the included studies, no conclusions can be drawn regarding the WOMET’s content validity, structure validity, cross-cultural validity, measurement error, or responsiveness. A further limitation of the studies included in this meta-analysis is the lack of cross-cultural validation, although recommended by the COSMIN Standards. Conclusions The first meta-analysis on measurement properties of the WOMET demonstrates satisfactory internal consistency, test-retest reliability, and construct validity. Further studies are needed, focusing on the methodological deficiencies highlighted in this meta-analysis. To ensure that the WOMET adequately reflects the symptoms, functions, and quality of life of patients with meniscal tears based on COSMIN criteria, it is necessary to assess the structural validity and content validity of this PROM.

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