Knee Stability after Double-bundle and Single-bundle Anterior Cruciate Ligament Reconstruction: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

SHI Junjun ,  JI Binping

Department of Orthopedics, The Second Affiliated Hospital of Shanxi Medical University, Taiyuan 030001, China;

Corresponding author：

JI Binping, Email: bpji@hotmail.com

Keywords：

Anterior cruciate ligament; Reconstruction; Double-bundle; Single-bundle; Systematic review

DOI：

10.7507/1672-2531.20080079

Video：

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Objective 　To evaluate knee stability after double-bundle and single-bundle anterior cruciate ligament reconstruction.
Methods 　Randomized controlled trials (RCTs) and quasi-randomized controlled trials (quasi-RCTs) were collected from MEDLINE (1966 to October 2007), OVID (1950 to October 2007), The Cochrane Library (issue 4, 2007) and China Academic Journals Full-text Database (1979 to October 2007). The quality of included trials was assessed. Data analyses were performed with The Cochrane Collaboration’s RevMan 4.2.10 software.
Results 　One RCT (quality B) and 5 quasi-RCTs (quality C) involving 426 patients met the inclusion criteria. Meta-analyses showed significant differences between the two operative procedures in terms of anterior stability (WMD –0.75, 95%CI –1.14 to –0.37, P=0.000 1) and rotational stability [RR 1.38, 95%CI 1.17 to 1.61, P lt;0.000 1].
Conclusion 　The double-bundle anterior cruciate liagament is superior to single-bundle anterior cruciate ligament in terms of anterior stability and rotational stability. Since the included trials were small and of poor quality, more high-quality, large-scale randomized controlled trials are required.

Citation： SHI Junjun,JI Binping. Knee Stability after Double-bundle and Single-bundle Anterior Cruciate Ligament Reconstruction: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2008, 08(5): 364-369. doi: 10.7507/1672-2531.20080079 Copy

1.	Voigt C, Schönaich M, Lill H. Anterior cruciate ligament reconstruction: state of the art. Eur J Trauma, 2006, 32: 332-329.
2.	Girgis FG, Marshall JL, Monajem A. The cruciate ligaments of the knee joint. Anatomical, functional and experimental analysis. Clin Orthop Relat Res, 1975, 106: 216-231.
3.	Ristanis S, Giakas G, Papageorgiou CD, et al. The effects of anterior cruciate ligament reconstruction on tibial rotation during pivoting after descending stairs. Knee Surg Sports Traumatol Arthrosc, 2003, 11(6): 360-365.
4.	Tashman S, Collon D, Anderson K, et al. Abnormal rotational knee motion during running after anterior cruciate ligament reconstruction. Am J Sports Med, 2004, 32(4): 975-983.
5.	Georgoulis AD, Ristanis S, Chouliaras V, et al. Anterior cruciate ligament reconstruction with a quadrupled hamstring autograft does not restore tibial rotation. Techniques in Orthopaedics, 2005, 20(3): 328-333.
6.	Georgoulis AD, Ristanis S, Chouliaras V, et al. Tibial rotation is not restored after ACL reconstruction with a hamstring graft. Clin Orthop Relat Res, 2007, 454: 89-94.
7.	Mae T, Shino K, Matsumoto N, et al. Force sharing between two grafts in the anatomical two-bundle anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc, 2006, 14(6): 505-509.
8.	Miura K, Woo SL, Brinkley R, et al. Effects of knee flexion angles for graft fixation on force distribution in double-bundle anterior cruciate ligament grafts. Am J Sports Med, 2006, 34: 577-585.
9.	Yagi M, Wong EK, Kanamori A, et al. Biomechanical analysis of an anatomic anterior cruciate ligament reconstruction. Am J Sports Med, 2002, 30: 660-666.
10.	Guardamagna L, Seedhom BB, Ostell AE. Double-band reconstruction of the ACL using a synthetic implant: a cadaveric study of knee laxity. J Orthop Sci, 2004, 9(4): 372-379.
11.	Petersen W, Tretow H, Weimann A, et al. One tibial tunnel versus two tibial tunnels biomechanical evaluation of two techniques for double-bundle anterior cruciate ligament reconstruction. Am J Sports Med, 2007, 35: 228-234.
12.	Järvelä T. Double-bundle versus single-bundle anterior cruciate ligament reconstruction: a prospective, randomize clinical study. Knee Surg Sports Traumatol Arthrosc, 2007, 15(5): 500-507.
13.	Järvelä T, Moisala AS, Sihvonen R, et al. Double-Bundle Anterior Cruciate Ligament Reconstruction Using Hamstring Autografts and Bioabsorbable Interference Screw Fixation: Prospective, Randomized Clinical Study with Two-Year Results. Am J Sports Med, 2007 Oct 16; [Epub ahead of print].
14.	Adachi N, Ochi M, Uchio Y, et al. Reconstruction of the anterior cruciate ligament. Single- versus double-bundle multistranded hamstring tendons. J Bone Joint Surg Br, 2004, 86(4): 515-520.
15.	Yasuda K, Kondo E, Ichiyama H, et al. Clinical evaluation of anatomic double-bundle anterior cruciate ligament reconstruction procedure using hamstring tendon grafts: comparisons among 3 different procedures. Arthroscopy, 2006, 22(3): 240-251.
16.	Muneta T, Koga H, Mochizuki T, et al. A prospective randomized study of 4-strand semitendinosus tendon anterior cruciate ligament reconstruction comparing single-bundle and double-bundle techniques. Arthroscopy, 2007, 23(6): 618-628.
17.	Yagi M, Kuroda R, Nagamune K, et al. Double-bundle ACL reconstruction can improve rotational stability. Clin Orthop Relat Res, 2007, 454: 100-107.
18.	Aglietti P, Giron F, Cuomo P, et al. Single-and double-incision double-bundle ACL reconstruction. Clin Orthop Relat Res, 2007, 454: 108-113.
19.	Steckel H, Starman JS, Baums MH, et al. Anatomy of the anterior cruciate ligament double bundle structure: a macroscopic evaluation. Scand J Med Sci Sports, 2007, 17(4): 387-392.
20.	Hara K, Kubo T, Suginoshita T, et al. Reconstruction of the anterior cruciate ligament using a double bundle. Arthroscopy, 2000, 16(8): 860–864.
21.	Sonnery-Cottet B, Chambat P. Anatomic double bundle: a new concept in anterior cruciate ligament reconstruction using quadriceps tendon. Arthroscopy, 2006, 22(11): 1249.e1-1249.e4.
22.	Yagi M, Wong EK, Kanamori A, et al. Biomechanical analysis of an anatomic anterior cruciate ligament reconstruction. Am J Sports Med, 2002, 30: 660-666.
23.	Cuomo P, Giron F, Bull A, et al. Double bundle anterior cruciate ligament reconstruction: an in vitro biomechanical study. J Bone Joint Surg Br Proceedings, 2006, 88-B: 426.
24.	Guardamagna L, Seedhom BB, Ostell AE. Double-band reconstruction of the ACL using a synthetic implant: a cadaveric study of knee laxity. J Orthop Sci, 2004, 9(4): 372-379.
25.	Asagumo H, Kimura M, Kobayashi Y. Anatomic reconstruction of the anterior cruciate ligament using double-bundle hamstring tendons: surgical techniques, clinical outcomes, and complications. Arthroscopy, 2007, 23(6): 602-609.

1. Voigt C, Schönaich M, Lill H. Anterior cruciate ligament reconstruction: state of the art. Eur J Trauma, 2006, 32: 332-329.
2. Girgis FG, Marshall JL, Monajem A. The cruciate ligaments of the knee joint. Anatomical, functional and experimental analysis. Clin Orthop Relat Res, 1975, 106: 216-231.
3. Ristanis S, Giakas G, Papageorgiou CD, et al. The effects of anterior cruciate ligament reconstruction on tibial rotation during pivoting after descending stairs. Knee Surg Sports Traumatol Arthrosc, 2003, 11(6): 360-365.
4. Tashman S, Collon D, Anderson K, et al. Abnormal rotational knee motion during running after anterior cruciate ligament reconstruction. Am J Sports Med, 2004, 32(4): 975-983.
5. Georgoulis AD, Ristanis S, Chouliaras V, et al. Anterior cruciate ligament reconstruction with a quadrupled hamstring autograft does not restore tibial rotation. Techniques in Orthopaedics, 2005, 20(3): 328-333.
6. Georgoulis AD, Ristanis S, Chouliaras V, et al. Tibial rotation is not restored after ACL reconstruction with a hamstring graft. Clin Orthop Relat Res, 2007, 454: 89-94.
7. Mae T, Shino K, Matsumoto N, et al. Force sharing between two grafts in the anatomical two-bundle anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc, 2006, 14(6): 505-509.
8. Miura K, Woo SL, Brinkley R, et al. Effects of knee flexion angles for graft fixation on force distribution in double-bundle anterior cruciate ligament grafts. Am J Sports Med, 2006, 34: 577-585.
9. Yagi M, Wong EK, Kanamori A, et al. Biomechanical analysis of an anatomic anterior cruciate ligament reconstruction. Am J Sports Med, 2002, 30: 660-666.
10. Guardamagna L, Seedhom BB, Ostell AE. Double-band reconstruction of the ACL using a synthetic implant: a cadaveric study of knee laxity. J Orthop Sci, 2004, 9(4): 372-379.
11. Petersen W, Tretow H, Weimann A, et al. One tibial tunnel versus two tibial tunnels biomechanical evaluation of two techniques for double-bundle anterior cruciate ligament reconstruction. Am J Sports Med, 2007, 35: 228-234.
12. Järvelä T. Double-bundle versus single-bundle anterior cruciate ligament reconstruction: a prospective, randomize clinical study. Knee Surg Sports Traumatol Arthrosc, 2007, 15(5): 500-507.
13. Järvelä T, Moisala AS, Sihvonen R, et al. Double-Bundle Anterior Cruciate Ligament Reconstruction Using Hamstring Autografts and Bioabsorbable Interference Screw Fixation: Prospective, Randomized Clinical Study with Two-Year Results. Am J Sports Med, 2007 Oct 16; [Epub ahead of print].
14. Adachi N, Ochi M, Uchio Y, et al. Reconstruction of the anterior cruciate ligament. Single- versus double-bundle multistranded hamstring tendons. J Bone Joint Surg Br, 2004, 86(4): 515-520.
15. Yasuda K, Kondo E, Ichiyama H, et al. Clinical evaluation of anatomic double-bundle anterior cruciate ligament reconstruction procedure using hamstring tendon grafts: comparisons among 3 different procedures. Arthroscopy, 2006, 22(3): 240-251.
16. Muneta T, Koga H, Mochizuki T, et al. A prospective randomized study of 4-strand semitendinosus tendon anterior cruciate ligament reconstruction comparing single-bundle and double-bundle techniques. Arthroscopy, 2007, 23(6): 618-628.
17. Yagi M, Kuroda R, Nagamune K, et al. Double-bundle ACL reconstruction can improve rotational stability. Clin Orthop Relat Res, 2007, 454: 100-107.
18. Aglietti P, Giron F, Cuomo P, et al. Single-and double-incision double-bundle ACL reconstruction. Clin Orthop Relat Res, 2007, 454: 108-113.
19. Steckel H, Starman JS, Baums MH, et al. Anatomy of the anterior cruciate ligament double bundle structure: a macroscopic evaluation. Scand J Med Sci Sports, 2007, 17(4): 387-392.
20. Hara K, Kubo T, Suginoshita T, et al. Reconstruction of the anterior cruciate ligament using a double bundle. Arthroscopy, 2000, 16(8): 860–864.
21. Sonnery-Cottet B, Chambat P. Anatomic double bundle: a new concept in anterior cruciate ligament reconstruction using quadriceps tendon. Arthroscopy, 2006, 22(11): 1249.e1-1249.e4.
22. Yagi M, Wong EK, Kanamori A, et al. Biomechanical analysis of an anatomic anterior cruciate ligament reconstruction. Am J Sports Med, 2002, 30: 660-666.
23. Cuomo P, Giron F, Bull A, et al. Double bundle anterior cruciate ligament reconstruction: an in vitro biomechanical study. J Bone Joint Surg Br Proceedings, 2006, 88-B: 426.
24. Guardamagna L, Seedhom BB, Ostell AE. Double-band reconstruction of the ACL using a synthetic implant: a cadaveric study of knee laxity. J Orthop Sci, 2004, 9(4): 372-379.
25. Asagumo H, Kimura M, Kobayashi Y. Anatomic reconstruction of the anterior cruciate ligament using double-bundle hamstring tendons: surgical techniques, clinical outcomes, and complications. Arthroscopy, 2007, 23(6): 602-609.

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Knee Stability after Double-bundle and Single-bundle Anterior Cruciate Ligament Reconstruction: A Systematic Review

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