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Double-Bundle Reconstruction of the Anterior Cruciate Ligament: Anatomic and Biomechanical Rationale

Dr. Zelle is Resident, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA. Dr. Vidal is Assistant Professor, Department of Orthopaedic Surgery, University of Colorado at Denver and Health Science Centers, Denver, CO. Dr. Brucker is Research Fellow, Department of Orthopaedic Surgery, Division of Sports Medicine, University of Pittsburgh. Dr. Fu is Chairman and David Silver Professor, Department of Orthopaedic Surgery, Division of Sports Medicine, University of Pittsburgh.

None of the following authors or the departments with which they are affiliated has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Zelle, Dr. Vidal, Dr. Brucker, and Dr. Fu.

Reprint requests: Dr. Fu, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Kaufmann Building, Suite 1011, 3471 Fifth Avenue, Pittsburgh, PA 15213.

Patients continue to suffer residual pain and instability following anterior cruciate ligament reconstruction. Although overall outcomes of anterior cruciate ligament reconstruction are favorable, improved outcomes can be achieved. Recent biomechanical studies have questioned the ability of conventional single-bundle anterior cruciate ligament constructs to adequately restore normal knee kinematics. Consequently, the use of double-bundle anterior cruciate ligament constructs has been recommended to restore knee stability more effectively. Recent biomechanical data indicate that double-bundle anterior cruciate ligament reconstruction may provide better anteroposterior and rotational knee stability than do conventional single-bundle techniques. Studies are needed to evaluate the clinical impact of double-bundle reconstruction techniques on long-term functional outcomes.

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