title: Single- versus double-bundle ACL reconstruction: is there any difference in stability and function at 3-year followup?
abstract: BACKGROUND
  Despite a number of studies comparing postoperative stability and function after anatomic double-bundle and single-bundle anterior cruciate ligament reconstruction (ACLR), it remains unclear whether double-bundle reconstruction improves stability or function.
  
  
  OBJECTIVE
  We therefore asked whether patients having single- and double-bundle ACLR using semitendinosus (ST) alone differed with regard to (1) postoperative stability; (2) ROM; and (3) five functional scores.
  
  
  METHODS
  We prospectively followed 60 patients with an isolated anterior cruciate ligament (ACL) injury. Thirty patients underwent single-bundle and 30 patients underwent double-bundle ACL reconstruction. Clinically we assessed stability and range of motion (ROM); anteroposterior stability was assessed by Rolimeter and rotational stability by a pivot shift test. Function was assessed by IKDC, Noyes, Lysholm, Marx, and Tegner activity scales. The minimum followup was 36 months (mean, 46.2 months; range, 36-60 months).
  
  
  RESULTS
  Residual anteroposterior laxity at 3 years postoperatively was similar in both groups: 1.4 ± 0.3 mm versus 1.4 ± 0.2 mm, respectively. We observed no difference in the pivot shift test. ROM was similar in both groups, although double-bundle patients required more physical therapy sessions to gain full ROM. IKDC, Noyes, Lysholm, Marx, and Tegner scores were similar at final followup.
  
  
  CONCLUSIONS
  Double-bundle reconstruction of the ACL did not improve function or stability compared with single-bundle reconstruction.
  
  
  METHODS
  Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
authors.affiliation: Orthopaedic Arthroscopic Surgery International, Via Amadeo GA 24, 20133 Milano, Italy. gobbi@cartilagedoctor.it
authors.forename: Alberto
authors.initials: A
authors.lastname: Gobbi
authors.forename: Vivek
authors.initials: V
authors.lastname: Mahajan
authors.forename: Georgios
authors.initials: G
authors.lastname: Karnatzikos
authors.forename: Norimasa
authors.initials: N
authors.lastname: Nakamura
mesh_terms: D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D001265:Athletic Injuries / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000503:physiopathology / Q000534:rehabilitation / Q000601:surgery*; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D011446:Prospective Studies; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012421:Rupture; D016896:Treatment Outcome