Anatomic single- versus double-bundle ACL reconstruction: a meta-analysis

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Fifteen randomized controlled trials and prospective comparative studies were included in this meta-analysis which compared knee kinematics and graft failure rates between anatomic single-bundle anterior cruciate ligament (ACL) reconstruction and anatomic double-bundle ACL reconstruction. Pooled estimates of knee laxity (side-to-side difference in AP laxity measured by KT-1000 and antero-posterior laxity measured by navigation) demonstrated significantly better outcome with anatomic double-bundle reconstruction, although no significant differences were found in pivot-shift, Lachman, and anterior drawer tests. Rate of graft failure also did not significantly differ between single- and double-bundle reconstructions. It has yet to be determined if these differences in laxity result in clinically meaningful improvements in patient important outcomes.