Summary

DB-ACLR is associated with better long-term subjective outcomes for patients with intact medial meniscus, patients with intact lateral meniscus, and those with concomitant ACL and lateral meniscus injuries, compared to SB-ACLR.

Abstract

Introduction

Single-bundle (SB) anterior cruciate ligament (ACL) reconstruction (ACLR) and double-bundle (DB) ACLR are common surgical techniques for ACL injury. The meniscus is crucial for knee stability. Meniscal tears and treatment strategies have been demonstrated to impact outcomes after ACLR. This study aims to compare long-term patient-reported outcomes between those undergoing SB-ACLR and DB-ACLR with different statuses of meniscal injury to identify the more appropriate surgical technique for this specific subgroup.

Methods

We retrospectively reviewed 138 patients undergoing SB-ACLR and 119 patients undergoing DB-ACLR at a single institution by a single surgeon from 2005 to 2014. Patient-reported outcomes were collected, which included the University of California Los Angeles (UCLA) Activity Score, the Lysholm Knee Score, the International Knee Documentation Committee (IKDC) Score, and the Tegner Activity Scale. The mean follow-up time was approximately 13.84 ± 2.88 years.

Results

In patients with intact medial meniscus (MM), those undergoing DB-ACLR showed significantly better outcomes compared to SB-ACLR (Lysholm 89.19 ± 9.86 vs. 81.72 ± 14.11, p < 0.001, IKDC 78.47 ± 8.46 vs. 72.67 ± 12.03, p = 0.001, Tegner 8.37 ± 1.88 vs. 7.54 ± 2.44, p =0.020). In patients with injured MM, there were no significant differences in outcomes. In patients with intact lateral meniscus (LM), patients undergoing DB-ACLR showed significantly better outcome (Lysholm 89.25 ± 10.39 vs 82.00 ± 13.25, p = 0.002; IKDC 78.35 ± 8.78 vs 71.55 ± 10.79, p = 0.001). In patients with injured LM, patients undergoing DB-ACLR showed significantly better outcomes (Lysholm 88.20 ± 9.07 vs. 82.98 ± 15.35, p = 0.010).

Conclusion

DB-ACLR is associated with better long-term subjective outcomes for patients with intact medial meniscus, patients with intact lateral meniscus, and those with concomitant ACL and lateral meniscus injuries, compared to SB-ACLR.