title: Second-look arthroscopic evaluation of chondral lesions after isolated anterior cruciate ligament reconstruction: single- versus double-bundle reconstruction.
abstract: BACKGROUND
  Double-bundle (DB) anterior cruciate ligament reconstruction (ACLR) has been reported to yield better joint stability than single-bundle (SB) reconstruction. Few studies have compared the 2 techniques with regard to postoperative articular cartilage changes.
  
  
  OBJECTIVE
  Less cartilage damage should occur in the short term after DB ACLR than after SB ACLR.
  
  
  METHODS
  Cohort study; Level of evidence, 2.
  
  
  METHODS
  The study included 52 patients (27 in the DB group and 25 in the SB group) with no chondral or meniscus injury at primary ACLR, as confirmed under arthroscopy. Four-strand and 6- to 8-strand hamstring autografts, respectively, were used for transtibial SB and 4-tunnel DB reconstruction. Each graft was fixed with an EndoButton bioabsorbable interference screw and a staple. Cartilage status at 6 identified regions was evaluated by second-look arthroscopy and the Outerbridge classification. Other assessments at final follow-up included International Knee Documentation Committee (IKDC) score, Tegner and Lysholm scores, side-to-side difference on KT-2000 arthrometer, and range of motion.
  
  
  RESULTS
  The mean time from reconstruction to second-look arthroscopy was 18.2 and 17.3 months for the DB and SB groups, respectively. Both groups had cartilage lesions at the patellofemoral joint (patella, 9 vs 13; trochlea, 5 vs 12) and the medial compartment (1 vs 2). Significantly less severe lesions were found in the DB group than in the SB group (mean grade, 0.33 vs 0.96; P < .05). No significant differences were found between the 2 groups in terms of cartilage status at other regions, IKDC score, Lysholm score, Tegner score, KT-2000 arthrometer anterior laxity, or range of motion.
  
  
  CONCLUSIONS
  Chondral lesions were found postoperatively in both DB and SB ACLR groups with hamstring autograft. The DB ALCR led to less cartilage damage at the femoral trochlea at short-term follow-up.
authors.affiliation: Jia-kuo Yu, Institute of Sports Medicine of Peking University, Peking University Third Hospital, No.49 North Garden Road, Haidian, Beijing, China 100191. yujiakuo@126.com.
authors.forename: Xi
authors.initials: X
authors.lastname: Gong
authors.forename: Dong
authors.initials: D
authors.lastname: Jiang
authors.forename: Yong-Jian
authors.initials: YJ
authors.lastname: Wang
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.forename: Ying-Fang
authors.initials: YF
authors.lastname: Ao
authors.forename: Jia-Kuo
authors.initials: JK
authors.lastname: Yu
mesh_terms: D000293:Adolescent; D000328:Adult; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D001182:Arthroscopy; D002358:Cartilage, Articular / Q000473:pathology*; D015331:Cohort Studies; D006801:Humans; D007718:Knee Injuries / Q000473:pathology*; D024162:Second-Look Surgery; D055815:Young Adult
keywords: anterior cruciate ligament; cartilage; double-bundle reconstruction; second-look arthroscopy