title: Individualized anterior cruciate ligament surgery: a prospective study comparing anatomic single- and double-bundle reconstruction.
abstract: BACKGROUND
  Reconstruction of the anterior cruciate ligament (ACL) has become a commonly performed procedure. However, biomechanical studies have demonstrated that conventional single-bundle ACL reconstruction techniques are only successful in limiting anterior tibial translation but less effective for restoring rotatory laxity.
  
  
  OBJECTIVE
  This study aimed to compare the results of single- and double-bundle ACL reconstruction using an anatomic technique, individualized based on the patient's native ACL size. The authors hypothesized that there would be no difference between the results of anatomic single-bundle (ASB) and anatomic double-bundle (ADB) reconstruction when the surgical technique is individualized.
  
  
  METHODS
  Cohort study; Level of evidence, 2.
  
  
  METHODS
  Depending on intraoperative measurements of the ACL insertion site size, patients were selected for either ASB (n = 32) or ADB (n = 69) ACL reconstruction. In all groups, hamstring tendons autograft was used with suspensory fixation on the femoral side and bioabsorbable interference screw fixation on the tibial side. The outcomes were evaluated by an independent blinded observer using the Lysholm score, subjective International Knee Documentation Committee (IKDC) form, KT-1000 arthrometer for anteroposterior stability, and pivot-shift test for rotational stability. The average follow-up was 30 months (range, 26-34 months). There were no statistically significant differences in the baseline demographics of the 2 groups.
  
  
  RESULTS
  There was no significant difference between the ADB and ASB groups for Lysholm score (93.9 vs 93.5), subjective IKDC score (93.3 vs 93.1), anterior tibial translation (1.5- vs 1.6-mm side-to-side difference), and pivot shift (92% vs 90% with negative pivot-shift examination).
  
  
  CONCLUSIONS
  Anatomic double-bundle reconstruction is not superior to anatomic single-bundle reconstruction when an individualized ACL reconstruction technique is used.
authors.affiliation: Artros Center for Orthopaedic Surgery and Sports Medicine, Tehnoloski park 21, 1000 Ljubljana, Slovenia. mhussein@artros.si
authors.forename: Mohsen
authors.initials: M
authors.lastname: Hussein
authors.forename: Carola F
authors.initials: CF
authors.lastname: van Eck
authors.forename: Andrej
authors.initials: A
authors.lastname: Cretnik
authors.forename: Dejan
authors.initials: D
authors.lastname: Dinevski
authors.forename: Freddie H
authors.initials: FH
authors.lastname: Fu
mesh_terms: D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D013710:Tendons / Q000637:transplantation*; D014182:Transplantation, Autologous; D055815:Young Adult