Single-bundle versus double-bundle anterior cruciate ligament reconstruction: a systematic review and meta-analysis

The aim of this analysis was to compare the functional outcomes, knee stability, and complications of patients after the arthroscopic double-bundle anterior cruciate ligament (ACL) reconstruction with those of singlebundle ACL reconstruction. An electronic search of the PubMed, EMBASE and Cochrane Library databases was performed. The analyzed outcomes were Lysholm scores, Tegner scores, subjective and objective International Knee Documentation Committee Scores (IKDC), Pivot-shift test, Lachman test, KT-1000/2000 measurement and complications. A total of 26 randomized controlled trials were available for this meta-analysis. The final results suggested that the double-bundle ACL reconstruction showed significant better outcomes in both functional outcomes and stability of knee joint, as assessed by the Lysholm scores, Tegner scores, objective IKDC, Pivot-shift test, Lachman test, and KT-1000/2000 (P<0.05). However, we found no evidence of a difference in subjective IKDC and complication rate. Based on current evidence, double-bundle ACL reconstruction appears to yield better outcomes when compared with single-bundle ACL reconstruction. However, the results should be interpreted with caution and further large-scale, well-designed RCTs on this topic are still needed.