Department of Forensic Medicine, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing, 400016, China.
Knee Surg Sports Traumatol Arthrosc. 2013 May;21(5):1085-96. doi: 10.1007/s00167-012-2073-8. Epub 2012 Jun 7.
To compare the short- and long-term clinical outcomes of the double-bundle (DB) anterior cruciate ligament (ACL) reconstruction with those of single-bundle (SB) ACL reconstruction.
An electronic search of the database PubMed (1966-September 2011), EMBASE (1984-September 2011), and Cochrane Controlled Trials Register (CENTRAL; 3rd Quarter, 2011) was undertaken to identify relevant studies. Main clinical outcomes were knee stability measurements including KT-1000 arthrometer measurement, Pivot shift test, and Lachman test, and clinical outcome measurements including International Knee Documentation Committee (IKDC), Lysholm knee score, Tegner activity score, and complications.
Eighteen studies were finally included in this meta-analysis, which were all classified as high risk of bias according to the Collaboration's recommended tool. It is seen that compared to SB ACL reconstruction, DB ACL reconstruction results in a KT-1000 arthrometer outcome 0.63 and 1.00 mm closer to the normal knee in a short- and long-term follow-up, respectively. Our results also reveal that DB-treated patients have a significantly higher negative rate of the pivot shift test (p < 0.00001 and = 0.006 in a short- and long-term follow-up, respectively) and Lachman test (n.s. and p < 0.0001 in a short- and long-term follow-up, respectively) compared to SB-treated patients. As for the clinical outcome measurements, a significant difference is found between SB versus DB ACL reconstruction regarding the IKDC (p = 0.006 and < 0.0001 in a short- and long-term follow-up, respectively) and complications (p = 0.03), while there is no significant difference between the two groups regarding Lysholm knee score (n.s.) and Tegner activity score (n.s.).
Overall, double-bundle ACL reconstruction yields better clinical outcomes when compared to single-bundle ACL reconstruction.
II.
比较双束（DB）前交叉韧带（ACL）重建与单束（SB）ACL 重建的短期和长期临床结果。
对数据库 PubMed（1966 年-2011 年 9 月）、EMBASE（1984 年-2011 年 9 月）和 Cochrane 对照试验登记处（CENTRAL；2011 年第 3 季度）进行电子检索，以确定相关研究。主要临床结果包括膝关节稳定性测量，包括 KT-1000 关节测量仪测量、髌股关节移位试验和lachman 试验，以及临床结果测量，包括国际膝关节文献委员会（IKDC）、Lysholm 膝关节评分、Tegner 活动评分和并发症。
最终有 18 项研究纳入了本次 meta 分析，根据协作组推荐的工具，这些研究均被归类为高偏倚风险。结果显示，与 SB ACL 重建相比，DB ACL 重建在短期和长期随访中，KT-1000 关节测量仪结果分别接近正常膝关节 0.63 和 1.00 毫米。我们的结果还表明，DB 治疗组的髌股关节移位试验（p<0.00001 和短期和长期随访中的 p=0.006）和lachman 试验（短期和长期随访中的 n.s. 和 p<0.0001）的阴性率明显高于 SB 治疗组。在临床结果测量方面，SB 与 DB ACL 重建在 IKDC（短期和长期随访中的 p=0.006 和<0.0001）和并发症（p=0.03）方面存在显著差异，而在 Lysholm 膝关节评分（n.s.）和 Tegner 活动评分（n.s.）方面两组之间无显著差异。
总体而言，与单束 ACL 重建相比，双束 ACL 重建的临床效果更好。
II 级。
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