Objective: To compare double bundle ACL reconstruction kinematics to single bundle reconstruction, intact knee and ACL deficient knee employing an electromagnetic device in six cadaver knees under different antero-posterior and rotational loading conditions.

Methods: All the tests were performed with an intact ACL, with a deficient ACL and after single and double bundle ACL reconstruction.

In double bundle ACL reconstruction two tibial tunnels were drilled: for the anteromedial the 65 degrees Howell guide was employed; the posterolaetral was drilled through a prototype jig attached to the first guide. Two femoral tunnels were drilled outside-in with the Rear Entry guide. A 6 millimetres bovine tendon graft was employed and fixed to bone with interference screws.

Results: Posterior drawer loading conditions did not show differences between intact knee, single and double ACL reconstruction independently from rotational stresses.

Under an anterior drawer test double bundle ACL reconstruction restored anteroposterior laxity significantly better than single bundle reconstruction at 20 and 40 degrees of flexion. A trend towards a better rotational control of double bundle reconstruction was observed in extension.