Single bundle reconstruction is preferred to double bundle

Abstract

Anterior cruciate ligament (ACL) reconstruction is one of the more common surgical procedures in sports medicine. The objective of the surgery is to restore knee stability by limiting tibial anterior translation and internal rotation. There has been recent interest in the double-bundle reconstruction technique in hopes of better restoring rotational control. While some comparative biomechanical analyses have shown that double-bundle reconstructions better resist internal tibial rotation, these findings are most frequently noted when double-bundle techniques are compared to nonanatomical single-bundle reconstructions. No improvement in clinical outcome has been noted with double-bundle reconstructions over anatomical single-bundle techniques. Meta-analyses on this subject are limited by the heterogeneity of surgical technique and reported outcomes. The literature currently does not support improved outcomes with double-bundle reconstruction over anatomic single-bundle reconstruction.