Prospective randomized comparison of anatomic single- and double-bundle anterior cruciate ligament reconstruction

Abstract

Both single- and double-bundle anatomic ACL reconstruction can restore the knee's stability and functions very well. However, more incidences of poor PL status and medial patellar-femoral cartilage damage may occur in double-bundle ACL reconstruction.

All-Inside Single-Bundle Reconstruction of the Anterior Cruciate Ligament with the Anterior Half of the Peroneus Longus Tendon Compared to the Semitendinosus Tendon: A Two-Year Follow-Up Study

“…29,50 On the tibial tunnel, the optimal anterior-posterior placement of the bone tunnel was proposed around 43%, ranging from 27 to 60% according to the Amis and Jakob line. 29,42 In our study, on average, the femoral tunnel's center was placed at 30.0% from the femoral length and at 33.8% from the femoral height. The anterior-posterior placement of the tibial tunnel was placed at 36.0% along the Amis and Jacob line, which was quiet consistent with other studies of anatomical reconstruction.…”

“…4,[39][40][41] Anatomical ACL reconstruction has become more popular as it is thought to restore knee function more normally. Although SB or DB anatomical ACL reconstruction is still in debate, 2,3,42,43 it seems that DB anatomical ACL reconstruction has had better results in anterior laxity and the pivot test. 2,[43][44][45] For example, in Aglietti et al's randomized controlled study, 43 patients in the DB group showed better VAS, objective IKDC scores, and knee laxity than in the SB group in the 2-year minimum follow-up.…”

“…Tunnel position locations in anatomical ACL insertion sites were believed to be the key points of excellent results of ACL anatomical reconstruction. 31,42,48,49 Malposition of the tunnel placement was considered to be the main technical failure in ACL reconstruction. Based on the development of radiography techniques and anatomical studies, 3D CT scans were widely used to assess the tunnel position after ACL reconstruction.…”

“…In SB anatomical reconstruction, the optimal placement of the tunnel position has been evaluated. 29,42 On the femoral side, the center of the tunnel was optimally located at 24 to 27% from the proximal condylar surface (parallel to the Blumensaat line), at 28 to 34% from the notch roof (perpendicular to the Blumensaat line). 29,50 On the tibial tunnel, the optimal anterior-posterior placement of the bone tunnel was proposed around 43%, ranging from 27 to 60% according to the Amis and Jakob line.…”

Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction With a Hamstring Tendon Autograft and Fresh-Frozen Allograft: A Prospective, Randomized, and Controlled Study

“…Several studies suggest that anatomic double-bundle (DB) ACL reconstruction could improve pivot-shift resistance, increase rotational knee control, help preserve menisci, and limit progression toward arthritis. [3][4][5][6][7] In a meta-analysis, 8 the authors analyzed the clinical outcomes of nonanatomic SB ACL reconstructions versus DB ACL reconstructions and they concluded better objective results of the DB technique, but subjective results showed no difference between the 2 groups. There was also extensive evidence supporting the SB ACL reconstruction with good clinical outcomes reported.…”