The Archives of Bone and Joint Surgery

The Archives of Bone and Joint Surgery

Double and Single Bundle in Athletes: A Comparison in Medium and Long-Term Rates to Return to Sport and Re-Injury

Document Type : RESEARCH PAPER

Authors
Alexandre Carneiro Bitar
Guilherme Abreu
Antonio Rodolpho Hakime Scalize
Guilherme Garofo
Caio D’Elia
Wagner Castropil
Instituto Vita, São Paulo, SP, Brazil
10.22038/abjs.2023.66143.3168
Abstract
Objectives: Compare, retrospectively, the medium- and long-term of return to sport rates and re-injury 
of the anterior cruciate ligament (ACL) in patients submitted to single -bundle (SB) compared to doublebundle (DB) technique reconstruction.
Methods: Athletes operated by SB or DB ACL reconstruction, with at least five years of follow-up at a single center, 
were included. The following data were collected: demographic data; competitive sports practice before the injury; 
previous surgery; injury/surgery to the contralateral knee; return to sports and level of the return; re-injury (time of 
the re-injury after the first surgery; mechanism of trauma for the re-injury; necessity of operative treatment); signs 
and complaints related to the knee the last clinical consultation.
Results: Seventy-six athletes (27 SB and 49 DB) were included. The return to sport rate (98%) was the same for 
both groups, and the return to the previous level rate showed an improvement in the DB group but without statistical 
significance (63% vs. 79%; P = 0.173). However, other outcomes showed higher results for the DB group: lower reinjury rate throughout the follow-up period (41% vs. 18%; P = 0.034) and during the first year of follow-up (22% vs. 
4%; P = 0.021), and less stiffness (0% vs. 22%, P = 0.001). While in primary reconstruction cases, there was not a 
higher re-injury rate using SB (P = 0.744), in the revision cases, SB was correlated with more re-injuries than DB (P 
= 0.002).
Conclusion: The overall re-injury in the medium- and long-term and the return to practice sports at the same level 
as before surgery in athletes submitted to DB reconstruction were slightly better than those submitted to SB 
reconstruction, especially in the cases that were asecond time lesion ( revisioned knees).
 Level of evidence: II
Keywords
Anterior cruciate ligament
Arthroscopy
Athletes
Double-bundle
Knee
Sport
Subjects
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The Archives of Bone and Joint Surgery
Volume 12, Issue 1
January 2024
Pages 19-25

  • Receive Date 27 June 2022
  • Revise Date 16 November 2023
  • Accept Date 27 September 2023