Elsenosy Abdelfatah M, Elnewishy Ahmed, Rezk Karim, Delewar Radwa A, Teama Hagar, Abdelfatah Aya M
Trauma and Orthopaedics, University Hospitals Dorset National Health Service (NHS) Foundation Trust, Poole, GBR.
Trauma and Orthopaedics, Royal Berkshire Hospital, Reading, GBR.
Cureus. 2024 Dec 9;16(12):e75352. doi: 10.7759/cureus.75352. eCollection 2024 Dec.
This systematic review and meta-analysis compares the effectiveness of single-bundle (SB) and double-bundle (DB) ACL reconstruction techniques in improving knee stability and functional outcomes in patients with ACL injuries. A structured search across PubMed, Scopus, Google Scholar, and the Cochrane Library identified studies comparing SB and DB ACL reconstructions. Ten studies met the inclusion criteria, including randomized controlled trials, prospective, and retrospective studies. The primary outcomes analyzed were the International Knee Documentation Committee (IKDC) subjective score, Lysholm score, Lachman test, and pivot-shift test results. Meta-analytic methods included calculating standardized mean differences (SMDs) and odds ratios (ORs) with 95% confidence intervals (CIs) alongside assessments of heterogeneity using the I² statistic. The meta-analysis showed no significant difference between SB and DB techniques for IKDC subjective scores (SMD: -0.14, 95% CI: -0.68 to 0.39, p = 0.59) or Lysholm scores (SMD: -0.18, 95% CI: -0.39 to 0.02, p = 0.08). Lachman test results also indicated no significant differences between techniques (pooled OR: 1.02, 95% CI: 0.70-1.47, p = 0.92). Pivot-shift test outcomes similarly revealed comparable rotational stability (OR: 1.00, 95% CI: 0.70-1.43, p = 1.00). Moderate heterogeneity was observed across analyses (I² = 37%-43%), reflecting variations in study designs and patient populations. SB and DB ACL reconstruction techniques achieve similar functional outcomes and knee stability, with no significant differences in Lachman test results, pivot-shift outcomes, or patient-reported measures. Further research with standardized methodologies is needed to verify these findings across diverse populations.
本系统评价和荟萃分析比较了单束（SB）和双束（DB）前交叉韧带（ACL）重建技术在改善ACL损伤患者膝关节稳定性和功能结局方面的有效性。通过对PubMed、Scopus、谷歌学术和考克兰图书馆进行结构化检索，确定了比较SB和DB ACL重建的研究。十项研究符合纳入标准，包括随机对照试验、前瞻性研究和回顾性研究。分析的主要结局指标为国际膝关节文献委员会（IKDC）主观评分、Lysholm评分、Lachman试验和轴移试验结果。荟萃分析方法包括计算标准化均数差（SMD）和比值比（OR）以及95%置信区间（CI），同时使用I²统计量评估异质性。荟萃分析显示，SB和DB技术在IKDC主观评分（SMD：-0.14，95%CI：-0.68至0.39，p = 0.59）或Lysholm评分（SMD：-0.18，95%CI：-0.39至0.02，p = 0.08）方面无显著差异。Lachman试验结果也表明技术之间无显著差异（合并OR：1.02，95%CI：0.70 - 1.47，p = 0.92）。轴移试验结果同样显示旋转稳定性相当（OR：1.00，95%CI：0.70 - 1.43，p = 1.00）。各分析中观察到中度异质性（I² = 37% - 43%），反映了研究设计和患者群体的差异。SB和DB ACL重建技术在功能结局和膝关节稳定性方面相似，在Lachman试验结果、轴移试验结果或患者报告的测量指标上无显著差异。需要采用标准化方法进行进一步研究，以在不同人群中验证这些发现。
