Journals / Acta Orthopaedica et Traumatologica Turcica / 2019 / Cilt: 53 - Sayı: 2

Long term results after double and single bundle ACL reconstruction: Is there any difference? A meta - analysis of randomized controlled trials

Pages
92–99
DOI
—
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

The pooled results showed no statistically significant difference between SB and double bundle DB reconstructions for Lysholm, IKDC, pivot shift, KT scores, and the development of osteoarthritis at a minimum of 5 years.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Objective: The double-bundle (DB) techniques are considered to yield better stability of the knee compared with single-bundle (SB) for anterior cruciate ligament (ACL) reconstruction.
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Key Findings & Data:However, most studies followed up patients in short to middle-term within 5 years, and the longer-term efficacy of SB and DB ACL reconstruction is still beyond consensus.
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Conclusion & Impact:The pooled results showed no statistically significant difference between SB and double bundle DB reconstructions for Lysholm, IKDC, pivot shift, KT scores, and the development of osteoarthritis at a minimum of 5 years.
🔬Design:Lab & Field Experiment
📍Scope:2017 Verileri
⚙️Variables:Domain Parameters

Özet

Objective: The double-bundle (DB) techniques are considered to yield better stability of the knee compared with single-bundle (SB) for anterior cruciate ligament (ACL) reconstruction. However, most studies followed up patients in short to middle-term within 5 years, and the longer-term efficacy of SB and DB ACL reconstruction is still beyond consensus. The purpose of this meta-analysis is to compare the longer-term efficacy between double-bundle (DB) and single-bundle (SB) techniques. Methods: PubMed, EMBASE, and Cochrane Library databases were searched for relevant articles published up to November, 2017 with an English language restriction. The searches were limited to human subjects and randomized controlled trials (RCTs). In addition, the reference lists of identified articles were checked manually to avoid missing other potentially eligible studies. This process was performed iteratively until no additional articles could be included. The quality of the included studies was assessed using The Cochrane Collaboration's risk of bias tool. All statistical analyses were performed with Review Manager soft-ware. Results: A total of five RCTs involving 294 patients were included finally. No studies were excluded due to insufficient data or low quality. The pooled results showed no statistically significant difference between SB and double bundle DB reconstructions for Lysholm, IKDC, pivot shift, KT scores, and the development of osteoarthritis at a minimum of 5 years. No significant heterogeneity was found across all outcomes. Conclusion: The best available evidence demonstrated that SB and DB techniques could yield similar efficacy for ACL reconstruction. And no superiority was founded in DB ACL reconstruction with a minimal 5-year follow-up. Given that, the relatively simple and proven techniques of SB ACL reconstruction may be preferable for orthopedic surgeons.

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Cite This Article

DONG, Z., NIU, Y., QI, J., SONG, Y., WANG, F. (2019). Long term results after double and single bundle ACL reconstruction: Is there any difference? A meta - analysis of randomized controlled trials. Acta Orthopaedica et Traumatologica Turcica, Cilt: 53 - Sayı: 2, 92–99. https://ajindex.com/articles/145909

References (12)

  1. Amis AA, Dawkins GP. Functional anatomy of the anterior cruciate ligament. Fibre bundle actions related to ligament replacements and injuries. J Bone Joint Surg Br. 1991
  2. 260e267. Griffin LY, Agel J, Albohm MJ, et al. Noncontact anterior cruciate ligament injuries: risk factors and prevention strategies. J Am Acad Orthop Surg. 2000
  3. 141e150. Swenson DM, Collins CL, Best TM, Flanigan DC, Fields SK, Comstock RD. Epidemiology of knee injuries among U.S. High school athletes, 2005/2006- 2010/2011. Med Sci Sports Exerc. 2013
  4. 462e469. Lohmander LS, Englund PM, Dahl LL, Roos EM. The long-term consequence of anterior cruciate ligament and meniscus injuries: Osteoarthritis. Am J Sports Med. 2007
  5. 1756e1769. Mott HW. Semitendinosus anatomic reconstruction for cruciate ligament insufficiency. Clin Orthop Relat Res139. 1983:90e92. Kondo E, Merican AM, Yasuda K, Amis AA. Biomechanical comparison of anatomic double-bundle, anatomic single-bundle, and nonanatomic singlebundle anterior cruciate ligament reconstructions. Am J Sports Med. 2011
  6. 279e288. Mascarenhas R, Cvetanovich GL, Sayegh ET, et al. Does double-bundle anterior cruciate ligament reconstruction improve postoperative knee stability compared with single-bundle techniques? A systematic review of overlapping meta-analyses. Arthroscopy. 2015
  7. 1185e1196. Chen G, Wang S. Comparison of single-bundle versus double-bundle anterior cruciate ligament reconstruction after a minimum of 3-year follow-up: a metaanalysis of randomized controlled trials. Int J Clin Exp Med. 2015
  8. 14604e14614. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the prisma statement. Int J Surg. 2010
  9. 336e341. Higgins JP, Altman DG, Gotzsche PC, et al. The cochrane collaboration's tool for assessing risk of bias in randomised trials. BMJ. 2011
  10. d5928. Zaffagnini S, Bruni D, Marcheggiani Muccioli GM, et al. Single-bundle patellar tendon versus non-anatomical double-bundle hamstrings acl reconstruction: a prospective randomized study at 8-year minimum follow-up. Knee Surg Sports Traumatol Arthrosc. 2011
  11. 390e397. Jarvela S, Kiekara T, Suomalainen P, Jarvela T. Double-bundle versus singlebundle anterior cruciate ligament reconstruction: a prospective randomized study with 10-year results. Am J Sports Med. 2017
  12. 2578e2585. Beyaz S, Güler ÜO, Demir S € ¸, et al. Tunnel widening after single- versus doublebundle anterior cruciate ligament reconstruction: a randomiz