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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 8, 995-999.
doi: 10.1302/0301-620X.90B8.20083  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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Double-bundle arthroscopic reconstruction of the anterior cruciate ligament

DOES THE EVIDENCE ADD UP?

U. G. Longo, MD, Resident in Trauma and Orthopaedic Surgery1; J. B. King, FRCS, FFSEM (UK), Consultant Orthopaedic Surgeon2; V. Denaro, MD, Professor of Trauma and Orthopaedic Surgery1; and N. Maffulli, MD, MS, PhD, FRCS (Orth), Professor of Trauma and Orthopaedic Surgery3

1 Department of Orthopaedic and Trauma Surgery, Campus Biomedico University, Via Alvaro del Portillo 200, 00128 Trigoria, Rome, Italy.
2 London Independent Hospital, Stepney Green, London E1 4NL, UK
3 Department of Orthopaedic and Trauma Surgery, University Hospital of North Staffordshire, Keele University School of Medicine, Stoke on Trent ST4 7LN, UK.

Correspondence should be sent to Professor N. Maffulli; e-mail: n.maffulli{at}orth.keele.ac.uk

There is a trend towards the use of double-bundle techniques for the reconstruction of the anterior cruciate ligament. This has not been substantiated scientifically. The functional outcome of these techniques is equivalent to that of single-bundle methods. The main advantage of a double-bundle rather than a single-bundle reconstruction should be a better rotational stability, but the validity and accuracy of systems for the measurement of rotational stability have not been confirmed.

Despite the enthusiasm of surgeons for the double-bundle technique, reconstruction with a single-bundle should remain the standard method for managing deficiency of the anterior cruciate ligament until strong evidence in favour of the use of the double-bundle method is available.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General