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A systematic review of single- versus double-bundle ACL reconstruction using the anatomic anterior cruciate ligament reconstruction scoring checklist

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The aim of this systematic review was to apply the anatomic ACL reconstruction scoring checklist (AARSC) and to evaluate the degree to which clinical studies comparing single-bundle (SB) and double-bundle (DB) ACL reconstructions are anatomic.

Methods

A systematic electronic search was performed using the databases PubMed (MEDLINE), EMBASE and Cochrane Library. Studies published from January 1995 to January 2014 comparing SB and DB ACL reconstructions with clinical outcome measurements were included. The items from the AARSC were recorded for both the SB and DB groups in each study.

Results

Eight-thousand nine-hundred and ninety-four studies were analysed, 77 were included. Randomized clinical trials (29; 38 %) and prospective comparative studies (29; 38 %) were the most frequent study type. Most studies were published in 2011 (19; 25 %). The most commonly reported items for both SB and DB groups were as follows: graft type (152; 99 %), femoral and tibial fixation method (149; 97 % respectively), knee flexion angle during graft tensioning (124; 81 %) and placement of the tibial tunnel at the ACL insertion site (101; 66 %). The highest level of documentation used for ACL tunnel position for both groups was often one dimensional, e.g. drawing, operative notes or o’clock reference. The DB reconstruction was in general more thoroughly reported. The means for the AARSC were 6.9 ± 2.8 for the SB group and 8.3 ± 2.8 for the DB group. Both means were below a proposed required minimum score of 10 for anatomic ACL reconstruction.

Conclusions

There was substantial underreporting of surgical data for both the SB and DB groups in clinical studies. This underreporting creates difficulties when analysing, comparing and pooling results of scientific studies on this subject.

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Acknowledgments

The authors did not receive any outside funding or grants directly related to the research presented in this manuscript. The Department of Orthopedic Surgery from the University of Pittsburgh receives funding from Smith and Nephew to support research related to reconstruction of the ACL.

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Authors and Affiliations

  1. Department of Orthopedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 431 80, Mölndal, Sweden

    Neel Desai, Jón Karlsson & Kristian Samuelsson

  2. Department of Orthopedic Surgery, Hospital del Mar – Parc de Salut Mar, Universitat Autonoma de Barcelona, Barcelona, Spain

    Eduard Alentorn-Geli

  3. Department of Orthopedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA

    Carola F. van Eck, Volker Musahl & Freddie H. Fu

Authors
  1. Neel Desai
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  2. Eduard Alentorn-Geli
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  3. Carola F. van Eck
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  4. Volker Musahl
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  5. Freddie H. Fu
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  6. Jón Karlsson
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  7. Kristian Samuelsson
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Corresponding author

Correspondence to Kristian Samuelsson.

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All authors contributed to the preparation of this work.

Appendix: Complete search string for systematic electronic search

Appendix: Complete search string for systematic electronic search

(‘Anterior Cruciate Ligament’ [Mesh] OR ‘anterior cruciate ligament’ [tiab] OR ACL [tiab]) AND (‘Surgical Procedures, Operative’ [Mesh] OR surgical [tiab] OR surgery [tiab] OR reconstruction [tiab] OR reconstructive [tiab] OR reconstructed [tiab]) AND (English [lang] AND (‘1995’ [PDAT]: ‘3000’ [PDAT])).

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Desai, N., Alentorn-Geli, E., van Eck, C.F. et al. A systematic review of single- versus double-bundle ACL reconstruction using the anatomic anterior cruciate ligament reconstruction scoring checklist. Knee Surg Sports Traumatol Arthrosc 24, 862–872 (2016). https://doi.org/10.1007/s00167-014-3393-7

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  • DOI: https://doi.org/10.1007/s00167-014-3393-7

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