Single- Vs. Double-Bundle ACL Reconstruction

Abstract

Multiple bundle ACL reconstruction, especially focused on doublebundle ACL reconstruction was discussed in this article. Although crucial factors and denominators that influence the outcome of ACL reconstruction are not elucidated, we believe that anatomically oriented graft replacement in reconstruction of the ruptured ACL structure will be certainly the future direction of this surgery. The study of anatomy of the ACL insertion site and intra-articular graft orientation in the young and normal population would be mandatory for the better understanding of future ACL reconstruction. Also better evaluation system that includes both subjective and objective approach should be refined in the future. As the technology advancement is seen in many fields of surgical technique, navigation system or some other types of newer technique will surely be introduced in ACL reconstruction technique field. Biological intervention of ACL surgery is surely one of the challenging issues for future ACL reconstruction. Since ACL is the tissue that has blood supply, biological application to facilitate the implanted graft to heal to normal ACL tissue may be one of the attainable possibilities and may be easier than healing of nonvascularized tissue like an articular cartilage damage or torn meniscus. We are still on the way to get the normal ACL tissue back to the torn ACL knee; however, anatomic approach of the double-bundle ACL reconstruction of the ACL tissue may be one of the possible solutions to this currently unsolved problem for the athletic population.