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Single-bundle versus split double-bundle technique for anterior cruciate ligament reconstruction
Arthrosc Orthop Sports Med 2024;11:23-29
Published online May 1, 2024;  https://doi.org/10.14517/aosm23022
© 2024 Korean Arthroscopy Society and Korean Orthopedic Society for Sports Medicine.

Chaemoon Lim, Jaeryun Lee, Yong Kim, Yong-Geun Park

Department of Orthopaedic Surgery, Jeju National University Hospital, Jeju, Korea
Correspondence to: Yong-Geun Park, https://orcid.org/0000-0002-9156-1203
Department of Orthopaedic Surgery, Jeju National University Hospital, 15 Aran 13-gil, Jeju 63241, Korea. Tel: +82-64-717-1690, Fax: +82-64-717-2714, E-mail: pyk184@hanmail.net
Received October 10, 2023; Revised January 2, 2024; Accepted January 15, 2024.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: There is much controversy regarding the effectiveness of the single-bundle (SB) and double-bundle (DB) techniques in anterior cruciate ligament reconstruction (ACLR). This study aimed to introduce a novel split DB technique and compare the clinical outcomes between the SB technique and our split DB technique.
Methods: A total of 150 patients meeting the criteria were included, with 93 and 57 patients undergoing SB and split DB ACLR, respectively. The split DB technique was performed using a single tibial and femoral bone tunnel. In all cases, a tibialis anterior tendon allograft was used. Clinical outcomes were evaluated using the Lysholm knee score, anterior drawer test, Lachman test, pivot shift test, and stability measurements using a Kneelax arthrometer (MR Systems).
Results: The Lysholm score of each technique significantly improved after surgery, and no significant difference was found between the two techniques (SB, 93.5 ± 7.6; DB, 94.8 ± 7.3; P = 0.658). Moreover, no significant differences were observed in the Lachman test (P = 0.537) and anterior drawer test (P = 0.371) results between the two techniques. However, the number of patients who underwent the pivot shift test was significantly larger in the SB group than in the split DB group (P = 0.041). The average anterior stability measured by an arthrometer was 2.3 mm in the SB technique and 1.4 mm in the split DB technique, which was significantly different (P = 0.008).
Conclusion: This split DB technique could provide better or at least similar results to the SB technique, and it may be a considerable option for ACLR.
Keywords : Single bundle; Double bundle; Anterior cruciate ligament
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May 2024, 11 (1)