Functional Outcome Comparison Between Single Bundle Versus Double Bundle in ACL Reconstruction: A Meta-Analysis

Authors

  • Risang Haryo Raditya Maranatha Christian University
  • I Gede Eka Wiratnaya Consultant, Orthopedics and Traumatology Department, Faculty of Medicine Udayana University, Prof.dr.I.G.N.G Ngoerah General Hospital, Denpasar, Bali, Indonesia

DOI:

https://doi.org/10.31282/joti.v6n3.119

Keywords:

Anterior cruciate ligament , ACL reconstruction, Single bundle, Double bundle, Lysholm score, IKDC score

Abstract

Introduction:
Anterior Cruciate Ligament (ACL) tears are a common and debilitating sports related injury, often necessitating surgical intervention for effective recovery. Two primary surgical techniques employed for ACL reconstruction are the Single Bundle (SB) and Double Bundle (DB) approaches. This meta-analysis aims to quantitatively assess and compare the outcomes of these two surgical methods in ACL tear patients, with a focus on functional outcome measures, specifically the Lysholm Score and the International Knee Documentation Committee (IKDC) Score.


Methods:
A thorough search of pertinent databases was executed to identify studies directly comparing SB and DB ACL reconstruction and reporting outcomes based on either the Lysholm Score or the IKDC Score. A total of eight studies met the inclusion criteria for Lysholm Score analysis, while seven studies were suitable for IKDC Score analysis, collectively involving 614 patients. The meta-analysis employed a random-effects model, and forest plots were utilized to visualize effect sizes and their associated confidence intervals.

Results:
The meta-analysis findings demonstrated a statistically significant difference favoring the Double Bundle approach concerning Lysholm Score outcomes (p <0.05). Patients undergoing Double Bundle ACL reconstruction exhibited superior Lysholm Scores compared to those undergoing the Single Bundle technique. Incontrast, the difference in IKDC Score outcomes between the two approaches was not statistically significant (p > 0.05). This implies that when using the IKDC Score as the functional outcome measure, there is no substantial divergence in patient outcomes between single-bundle and double-bundle ACL reconstruction

Conclusion:
In summary, this meta-analysis provides evidence that double-bundle ACL reconstruction leads to improved outcomes in terms of the Lysholm Score when compared to single-bundle reconstruction. However, no significant disparities were observed between the two techniques when the IKDC Score was used to evaluate functional outcomes. Consequently, both Single Bundle and Double Bundle ACL reconstruction can be considered viable treatment options for ACL tears. The selection between these approaches should be based on patient-specific factors and the expertise of the surgeon. Further research, particularly randomized controlled trials, may offer more nuanced insights into the optimal surgical
approach for distinct subsets of ACL tear patients.

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Additional Files

Published

2023-12-30