title: Arthroscopic anatomical double bundle anterior cruciate ligament reconstruction: A prospective longitudinal study.
abstract: BACKGROUND
  Single bundle anterior cruciate ligament (ACL) reconstruction has been the current standard of treatment for ACL deficiency. However, a significant subset of patients continue to report residual symptoms of instability with a poor pivot control. Cadaveric biomechanical studies have shown double bundle (DB) ACL reconstructions to restore the knee kinematics better. This study evaluates the outcome of DB ACL reconstruction.
  
  
  METHODS
  30 consecutive patients who underwent anatomic DB ACL reconstruction were included in this prospective longitudinal study. There were all males with a mean age of 25 ± 7.45 years. All patients were prospectively evaluated using GeNouRoB (GNRB) arthrometer, functional knee scores (International Knee Documentation Committee [IKDC] and Lysholm) and postoperative magnetic resonance imaging (MRI) for comparing the graft orientation and footprint of the reconstructed ACL with that of the normal knee.
  
  
  RESULTS
  The average followup was 36.2 months. At the time of final followup the mean Lysholm score was 93.13 ± 3.31. As per the objective IKDC score, 26 patients (86.6%) were in Group A while 4 patients (13.3%) were in Group B. The mean differential anterior tibial translation by GNRB, arthrometer was 1.07 ± 0.8 mm (range 0.1-2.3 mm). All cases had a negative pivot shift test. MRI scans of operated and the contralateral normal knee showed the mean sagittal ACL tibial angle coronal ACL tibial angle and tibial ACL footprint to be in accordance with the values of the contralateral, normal knee.
  
  
  CONCLUSIONS
  The study demonstrates that DB ACL reconstruction restores the ACL anatomically in terms of size and angle of orientation. However, long term studies are needed to further substantiate its role in decreasing the incidence of early osteoarthritic changes compared to the conventional single bundle reconstructions.
authors.affiliation: Department of Orthopaedics and Rehabilitation, PGIMS, Rohtak, Haryana, India.
authors.forename: Ashish
authors.initials: A
authors.lastname: Devgan
authors.affiliation: Department of Orthopaedics and Rehabilitation, PGIMS, Rohtak, Haryana, India.
authors.forename: Amanpreet
authors.initials: A
authors.lastname: Singh
authors.affiliation: Department of Orthopaedics and Rehabilitation, PGIMS, Rohtak, Haryana, India.
authors.forename: Paritosh
authors.initials: P
authors.lastname: Gogna
authors.affiliation: Department of Orthopaedics and Rehabilitation, PGIMS, Rohtak, Haryana, India.
authors.forename: Rohit
authors.initials: R
authors.lastname: Singla
authors.affiliation: Department of Orthopaedics and Rehabilitation, PGIMS, Rohtak, Haryana, India.
authors.forename: Narender Kumar
authors.initials: NK
authors.lastname: Magu
authors.affiliation: Department of Orthopaedics and Rehabilitation, PGIMS, Rohtak, Haryana, India.
authors.forename: Reetadyuti
authors.initials: R
authors.lastname: Mukhopadhyay
keywords: Arthroscopy; anterior cruciate ligament; anterior cruciate ligament reconstruction; double bundle; reconstruction