Double bundle ACL reconstruction tied to better IKDC objective grading at 15 year follow up compared to single bundle reconstruction: study

Patients were randomly assigned to either the SB group (n=78) or the DB group (n=75). Evaluation included clinical testing, subjective assessments, functional testing, and International Knee Documentation Committee (IKDC) objective grading. Surgical techniques were anatomic, and the rehabilitation protocol was standardized.

Key findings of the study were:

• At 15-year follow-up, information was available on 100 patients (65%), of whom 55 (36%) were accepted in the final statistical analysis.

• During the 15-year follow-up period, 11 patients in each group sustained ACL tear in the contralateral knee. Moreover, four patients (5%) in the SB group and one patient (1%) in the DB group underwent total knee replacement.

• The median and mean of the follow-up time were 16.3 years (14.6–17.1) and 15.9 years (1.4), respectively.

• There were almost three times as many graft failures in the SB group, but the result wasn´t statistically significant.

• Anterior tibial translation was measured with the KT -1000 arthrometer. The median difference (index minus opposite) was 1 mm in both groups, and the IQR was -1 to 2 mm in the SB group and 0 to 2 mm in the DB group.

• Knee rotational stability was assessed with the pivot shift test. In total, 23 (79%) patients in the SB group and 23 patients (89%) in the DB group had a negative pivot shift test result.

• Subjective assessments, knee stability (KT -1000 and pivot shift), range of motion (ROM), and functional one leg hop test showed no statistically significant differences between the groups.

• However, DB ACL reconstruction resulted in better International Knee Documentation Committee objective grading (P<0.001).

“The main finding of this 15-year follow-up study was that the double-bundle technique resulted in better IKDC objective grading. Otherwise, no difference between the groups was demonstrated” – the authors commented.

Further reading:

Double bundle anterior cruciate ligament reconstruction resulted in better International Knee Documentation Committee objective grading at ffteen year follow up compared to single bundle reconstruction. Arttu Seppänen et al International Orthopaedics (2024) 48:905–912 https://doi.org/10.1007/s00264-024-06106-7