Oh Jin-Young, Kim Kun-Tae, Park Young-Jin, Won Hee-Chan, Yoo Jun-Il, Moon Dong-Kyu, Cho Sung-Hee, Hwang Sun-Chul
Department of Orthopaedic Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, 15, Jinju-daero 816 beon-gil, Jinju-si, Gyeongsangnam-do, Republic of Korea, 660-751.
Knee Surg Relat Res. 2020 Mar 12;32(1):14. doi: 10.1186/s43019-020-00033-8.
Of the many issues regarding surgical techniques related to anterior cruciate ligament reconstruction (ACLR), single-bundle (SB) or double-bundle (DB) ACLR is one of the most debated topics. However, it is unclear which of the techniques yields better outcomes after ACLR for ACL injury. The purpose of this meta-analysis was to compare the benefits of SB versus DB ACLR in terms of biomechanical outcomes.
The electronic databases MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, and Scopus were searched for relevant articles comparing the outcomes of SB-ACLR versus DB-ACLR that were published until November 2019.
Seventeen biomechanical studies were included. The anterior laxity measured using the anterior drawer test showed significantly better results in DB-ACLR when compared with SB-ACLR. In addition, outcomes of the anterior tibial translation test under a simulated pivot shift presented with better results at low flexion and 30° in DB-ACLR, compared with SB-ACLR. However, there were no significant biomechanical differences between the groups in internal rotation.
The present study demonstrated that both techniques for ACLR are associated with restoration of normal knee kinematics. DB-ACLR is superior to SB-ACLR in terms of restoration of anteroposterior stability. However, which technique yields better improvement in internal rotation laxity, and internal rotation laxity under a simulated pivot shift at a specific angle, remains unclear.
This is a level II meta-analysis.
在与前交叉韧带重建（ACLR）相关的众多手术技术问题中，单束（SB）或双束（DB）ACLR是最具争议的话题之一。然而，对于ACL损伤的ACLR后哪种技术能产生更好的结果尚不清楚。本荟萃分析的目的是比较SB与DB ACLR在生物力学结果方面的益处。
检索电子数据库MEDLINE、Embase、Cochrane对照试验中央注册库、科学网和Scopus，以查找截至2019年11月发表的比较SB-ACLR与DB-ACLR结果的相关文章。
纳入了17项生物力学研究。与SB-ACLR相比，使用前抽屉试验测量的前向松弛度在DB-ACLR中显示出明显更好的结果。此外，在模拟轴移下的胫骨前向平移试验结果显示，与SB-ACLR相比，DB-ACLR在低屈曲度和30°时表现更好。然而，两组在内部旋转方面没有显著的生物力学差异。
本研究表明，两种ACLR技术均与正常膝关节运动学的恢复相关。在恢复前后稳定性方面，DB-ACLR优于SB-ACLR。然而，哪种技术在内部旋转松弛度以及特定角度模拟轴移下的内部旋转松弛度方面改善更好，仍不清楚。
这是一项II级荟萃分析。
