Single-Bundle vs. Double-Bundle ACL Reconstruction: Comparison of Joint Stability and Cartilage Integrity

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Introduction: The double-bundle ACL (DBACL) or single-bundle ACL (SBACL) reconstruction technique is a surgical technique to repair a ruptured ACL. Examination of the Lachman test, Pivot test, and rolimeter represent the anterior and rotational stability of the knee joint. In addition, MRI T2-map can provide an overview of joint cartilage integrity. Therefore, the best ACL reconstruction technique can be identified by analyzing joint stability and cartilage integrity changes. Methods: A single-blind randomized clinical trial was conducted to determine whether DBACL reconstruction is superior to SBACL in subclinical joint stability and cartilage integrity measurements. Lachman test, pivot test, rolimeter, and the MRI T2-map assessment were evaluated on both groups. The normality tests on the characteristics of the subjects, joint stability, and cartilage integrity were conducted, followed by paired and unpaired statistical tests. Results: Of the 43 patients analyzed, 22 were allocated to the SBACL group and 21 to the DBACL group. No significant difference was found on the Lachman test (p=0.849, p=0.126, and p=0.466), pivot test (p=0.877, p=0.678, p=0.904), and rolimeter (p=0.395, p=0.566, p =0.455), as well as MRI T2-map (p=0.145, p= 0.481, p= 0.114), and MRI T2-map semiquantitative (p=0.970, p =0.643, p=0.190) in both groups before, after three, and six months surgery. The mean value of the joint stability examination for each group improved from before, after three, and six months of surgery (p<0.05). The SBACL and DBACL groups had no significant difference in MRI T2-map (SBACL, p=0.055; DBACL, p=0.717) and MRI T2-map semiquantitative (SBACL, p=0.05; DBACL, p=0.06) at three and six months. Rolimeter examination did not significantly correlate with MRI T2-map. Conclusion: DBACL reconstruction provides results that are equivalent to SBACL in Lachman tests, pivot tests, rolimeter, and MRI T2-map, and there is no significant relationship between joint stability and MRI T2-map after both reconstructions.

Original languageEnglish
Pages (from-to)123-130
Number of pages8
JournalBali Medical Journal
Issue number1
Publication statusPublished - 2023


  • ACL reconstruction
  • cartilage injury
  • knee joint stability
  • Lachman test
  • MRI T2-map


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