Kondo Eiji, Yasuda Kazunori, Azuma Hirotaka, Tanabe Yoshie, Yagi Tomonori
Department of Sports Medicine and Joint Reconstruction Surgery, Hokkaido University School of Medicine, Kita-15 Nishi-7, Kita-ku, Sapporo 060-8638, Japan.
Am J Sports Med. 2008 Sep;36(9):1675-87. doi: 10.1177/0363546508317123. Epub 2008 May 19.
Several trials have been conducted to compare the clinical results between anatomic double-bundle and single-bundle anterior cruciate ligament (ACL) reconstruction procedures. In these studies, however, the number of patients was insufficient to compare the clinical results of the 2 procedures.
The anatomic double-bundle procedure may be significantly better concerning the anterior laxity and the pivot-shift test than the single-bundle procedure, while there may be no significant differences in the other clinical evaluations and the intra-operative and postoperative complications between the 2 procedures.
Cohort study; Level of evidence, 2.
Three hundred and twenty-eight patients with unilateral ACL reconstruction using hamstring autografts were divided into 2 groups. The first 157 consecutive patients underwent single-bundle reconstruction and the remaining 171 patients underwent anatomic double-bundle reconstruction. Concerning all background factors, there were no statistical differences between the 2 groups. Each patient was examined 2 years after surgery.
No serious complications were experienced in either group. The anterior laxity was significantly less in the double-bundle reconstruction (mean, 1.2 mm) than in the single-bundle reconstruction (mean, 2.5 mm). In the pivot-shift test, the double bundle (+ indication, 16%; ++, 3%) was significantly better than the single bundle (+ result, 37%; ++, 12%). The mean Lysholm score averaged 96.5 points and 97.3 points in single-bundle and double-bundle reconstructions, respectively, while the International Knee Documentation Committee evaluation showed that 90 and 110 patients, respectively, were evaluated as rank A (no significant difference between groups). There were no significant differences in the other clinical evaluations and the complications between the 2 procedures.
The postoperative anterior and rotational stability after the anatomic double-bundle ACL reconstruction was significantly better than that after the single-bundle reconstruction, although there were no significant differences between the 2 procedures concerning the complications and the clinical evaluations.
已开展多项试验比较解剖双束与单束前交叉韧带（ACL）重建手术的临床结果。然而，在这些研究中，患者数量不足以比较这两种手术的临床结果。
与单束手术相比，解剖双束手术在前侧松弛度和轴移试验方面可能显著更优，而在其他临床评估以及两种手术的术中及术后并发症方面可能无显著差异。
队列研究；证据等级，2级。
328例采用自体腘绳肌腱进行单侧ACL重建的患者被分为两组。前157例连续患者接受单束重建，其余171例患者接受解剖双束重建。在所有背景因素方面，两组之间无统计学差异。每位患者在术后2年接受检查。
两组均未出现严重并发症。双束重建的前侧松弛度（平均1.2毫米）显著小于单束重建（平均2.5毫米）。在轴移试验中，双束（+阳性，16%；++，3%）显著优于单束（+阳性，37%；++，12%）。单束和双束重建的Lysholm评分平均分别为96.5分和97.3分，而国际膝关节文献委员会评估显示，分别有90例和110例患者被评为A级（两组之间无显著差异）。两种手术在其他临床评估和并发症方面无显著差异。
解剖双束ACL重建术后的前侧和旋转稳定性显著优于单束重建，尽管在并发症和临床评估方面两种手术之间无显著差异。
