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Article Abstract
Background: The present study was aimed to compare the clinical outcomes following double-bundle (DB) ACL reconstruction (ACLR) with the outcomes following single-bundle (SB) ACLR in skeletally mature teenagers.
Methods: A total of 113 skeletally mature teenagers with unilateral ACL injury, who underwent primary ACLR using hamstring autograft with minimum 2 years follow-up, were included. This included 82 DB ACLR (median 16.0 [interquartile range (IQR), 2.0] year-old, male/female: 21/61) and 31 SB ACLR (17.0 [2.0] year-old, male/female: 6/25). At the final follow-up (3.6 [1.9] years), IKDC Subjective Knee Form (IKDC-SKF), Tegner activity scale, the side-to-side difference (SSD) in anterior tibial translation using KT arthrometer were obtained. The rate of residual pivot-shift test, graft rupture rate and contralateral ACL injury rate were also assessed.
Results: The rate of residual pivot-shift test was significantly lower in DB group than SB group (12.0 % vs 33.3 %, P = 0.02). Postoperative Tegner activity scale was significantly greater in DB group (7 [2]) than SB group (4 [4], P = 0.002). No significant differences were observed between two groups in IKDC-SKF (96.6 [10.0] in DB group, 97.7 [9.0] in SB group) and SSD in anterior tibial translation (1.5 [2.0] mm in DB group, 2.0 [2.0] mm in SB group). Graft rupture occurred in seven patients in DB group (8.5 %), and one patient in SB group (3.3 %). Contralateral ACL injury occurred in four patients in DB group (4.9 %), and two patients in SB group (6.5 %). No significant differences were observed between two groups in graft rupture and the contralateral ACL injury rates.
Conclusion: Clinical outcomes following DB ACLR were similar to SB ACLR, but the pivot-shift phenomenon appeared to be better controlled in DB ACLR than SB ACLR. Thus, to better restore rotatory knee stability, DB ACLR may be recommended in the skeletally mature teenagers.
Level Of Evidence: III.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC12173021 | PMC |
| http://dx.doi.org/10.1016/j.asmart.2025.04.006 | DOI Listing |
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