Abstract
Introduction: Double bundle anterior cruciate ligament (DBACL) reconstruction has been shown to improve objective measurements of rotational stability. However, subjective improvement in patient outcome has yet to be shown. The aim of this study was to investigate whether double bundle ACL reconstruction could provide satisfactory subjective and objective outcome in a consecutive patient series at a minimum of two years post operatively.
Methods: From May 2006 a consecutive group of patients underwent double bundle ACL reconstruction using doubled semitendinosus (anteromedial bundle) and gracilis (posterolateral bundle) tendons fixed with interference screws in both femur and tibia. Pre and post operative subjective and objective IKDC 2000 knee scores were collected including pivot shift and KT-1000 arthrometer assessments. A comparison was made to a cohort of single bundle ACL reconstructions performed by the same surgeon whose data was collected previously.
Results: The group included 29 patients (26 male, mean age 30; range 18–47). A significant improvement in subjective IKDC 2000 score between preop (54.8) and last follow up (76.3) was shown (p = 0.00); 96% of subjects were IKDC grade A or B; 85% of subjects had a negative pivot shift on last review with 15% eliciting a pivot glide. There were no differences in subjective or objective outcomes between the double bundle and single bundle groups.
Discussion: This data compares favourably with other published series of double bundle ACL reconstruction. Although subjective improvement in functional outcome is seen, early results do not show an improvement over single bundle reconstruction. It remains to be shown if this technique will confer an overall improvement in long term outcome via the more anatomical reconstruction.
Correspondence should be addressed to: BASK c/o BOA, at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London, WC2A 3PE, England.
