title: Comparison Between Single- and Double-Bundle Anterior Cruciate Ligament Reconstruction With 6- to 8-Stranded Hamstring Autograft: A Prospective, Randomized Clinical Trial.
abstract: Whether double-bundle (DB) anterior cruciate ligament (ACL) reconstruction with 6- to 8-stranded hamstring autograft (HG) is better than single-bundle (SB) ACL reconstruction remains debatable, as long-term follow-up data are lacking.
  
  
  
  To prospectively investigate and compare the long-term results of DB and SB ACL reconstruction with a 6- to 8-stranded HG.
  
  
  
  Randomized controlled clinical trial;
  
  
  
  1.
  
  
  
  A total of 80 patients with chronic ACL rupture were randomized to SB or DB ACL reconstruction with a 6- to 8-stranded HG. In the SB group, both the semitendinosus tendon (ST) and the gracilis tendon (GT) were prepared in 3 or 4 strands, with a total of 6 to 8 strands. In the DB group, the ST was prepared in 3 or 4 strands used for the anteromedial bundle, and the GT was prepared in the same manner for the posterolateral bundle. Each graft was fixed with an EndoButton, a bioabsorbable interference screw, and a staple. Outcome assessment was performed by a blinded independent observer using International Knee Documentation Committee (IKDC), Tegner, and Lysholm scores, as well as range of motion (ROM), Lachman test, pivot-shift test, KT-2000 arthrometer side-to-side difference, and return-to-sport data.
  
  
  
  A total of 68 patients (DB group, 34; SB group, 34) were observed for a mean of 80 months (range, 74-86 months). There were 2 traumatic instability failures and two 5° extension restrictions in the DB group, while no failures or 5° extension restrictions were observed in the SB group. The mean Lysholm, Tegner, and IKDC scores improved significantly in both groups compared with preoperation scores (P < .05). No patient had a positive Lachman test result. No significant differences were found between groups in functional scores, incidence of pivot shift, ROM, Lachman test, KT-2000 arthrometer anterior laxity, or time and level of return to sport.
  
  
  
  Both SB and DB ACL reconstruction with 6- to 8-stranded HG showed satisfactory results in subjective scores and anteroposterior and rotational stability over a nearly 7-year follow-up; neither technique was superior.
authors.affiliation: Institute of Sports Medicine, Peking University Third Hospital, Beijing, China.
authors.forename: Yulei
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Institute of Sports Medicine, Peking University Third Hospital, Beijing, China.
authors.forename: Guoqing
authors.initials: G
authors.lastname: Cui
authors.affiliation: Institute of Sports Medicine, Peking University Third Hospital, Beijing, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Yan
authors.affiliation: Institute of Sports Medicine, Peking University Third Hospital, Beijing, China.
authors.forename: Yuping
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Institute of Sports Medicine, Peking University Third Hospital, Beijing, China yingfang.ao@vip.sina.com.
authors.forename: Yingfang
authors.initials: Y
authors.lastname: Ao
mesh_terms: D000293:Adolescent; D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries / Q000601:surgery*; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D064592:Autografts / Q000637:transplantation*; D005260:Female; D000070632:Hamstring Tendons / Q000637:transplantation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016059:Range of Motion, Articular; D055815:Young Adult
keywords: anterior cruciate ligament; double-bundle reconstruction; hamstring tendon; single-bundle reconstruction