Cochrane in CORR ^®: Double-bundle Versus Single-bundle Reconstruction for Anterior Cruciate Ligament Rupture in Adults (Review)

Excerpt

Anterior cruciate ligament (ACL) injuries most commonly occur in young, active patients, with an annual incidence of more than 200,000 in the United States alone [8, 11, 13]. Approximately 65% of these patients undergo ACL reconstruction, but there is ongoing debate about the most appropriate techniques [6]. Earlier studies have explored the importance of tunnel placement, graft selection, graft fixation, and rehabilitation protocols, but recent attention has focused on the role of double-bundle reconstruction [2]. The native ACL consists of two discrete anteromedial and posterolateral bundles, which respectively account for translational and rotational stability [9, 10, 13]. Double-bundle ACL reconstruction involves reconstructing each of these bundles separately and is purported to more closely restore native knee anatomy and biomechanics. However, double-bundle ACL reconstructions are more technically demanding than conventional single-bundle techniques, they require greater operative time, and are more difficult to revise when they fail [10]. …