Rotational Stability of the Knee in a Comparative Study of Anterior Cruciate Ligament Reconstruction Using the Double-Bundle and Single-Bundle Techniques

Document Type : RESEARCH PAPER


1 1 Instituto de Ortopedia e Traumatologia (IOT), Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil 2 Instituto Vita, São Paulo, SP, Brazil

2 Instituto Vita, São Paulo, SP, Brazil

3 Instituto Vita, Sao Paulo, SP, Brazil

4 Universidade Federal do ABC, Santo André, SP, Brazil

5 Instituto de Ortopedia e Traumatologia (IOT), Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil


Background: The purpsose of this study was to evaluate the biomechanical outcomes of patients who underwent ACL 
reconstruction either with the DB or SB technique. We hypothesized that the DB technique would provide better rotation 
control of the knee following ACL reconstruction. 
Methods: The study included seventy-five participants (26 DB, 22 SB, and 27 healthy volunteers). Only cases 
with at least one year of postoperative follow-up were included. The participants performed three different demand 
tasks: walk task, walk and change direction, and stair descent and change direction, which was tracked using a 
three-dimensional 4-camera optoelectronic system. The following kinematic data were analyzed: tibial rotation 
amplitude and maximal internal and external rotation. Knees with ACL reconstruction were compared to contralateral 
knees with intact ACL and healthy knees. Clinical outcomes were determined using the subjective and objective 
International Knee Documentation Committee (IKDC) questionnaire and a manual arthrometer (KT 1000). 
Results: Both surgical groups exhibited similar clinical outcomes (mean subjective IKDC 91 SB vs. 90 DB, P=0.815; 
KT 1000 difference: 2mm in both groups, P=0.772). The vertical component of the ground force reaction revealed 
no differences between the surgical and control groups (P>0.05). Tibial rotation amplitude and maximal internal and 
external rotation were similar between the control, SB, and DB groups in all three different demand tasks (P>0.05).
Conclusion: ACL reconstruction using either the SB or DB technique can restore rotational control to the level of a 
healthy knee. No clinical or functional differences were found between the SB and DB surgical options.
Level of evidence: II


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