What Is A Double-Bundle ACL Reconstruction?

Dr. Matava describes a double-bundle anterior cruciate ligament (ACL) reconstruction.

Dr. Matava:
Well, the most cutting-edge topic available nowadays is the so-called double-bundle reconstruction, and what that means is, is that typically the ACL was reconstructed by using a single bundle of tissue in order to act as a sort of checkrein to hold the knee in place and if you look anatomically, the ACL is probably composed of two main fiber bundles. And so what some surgeons have advocated is, as opposed to just replacing just the one ligament bundle, you replace two of them.

Now with that, there comes a higher risk of complications because now instead of just drilling two tunnels in the bone, you are drilling four tunnels; instead of using two screws to hold the graft in place, you are using four screws. And so, not only is the complication rate potentially higher, but so is the cost of the operation potentially higher. Thus far, there has not been any good clinical data that suggests that doing this new double-bundle method is any better than doing this single bundle reconstruction that is currently done.

About Dr. Matava, M.D.:
Dr. Matthew J. Matava, M.D., is an associate professor and orthopedic surgeon at Washington University School of Medicine in St. Louis. Specializing in sports medicine, his clinical areas of interest include ligament injuries of the knee, athletic injuries of the shoulder and elbow, and pediatric orthopedic knee disorders.

Visit Dr. Matava at Washington University School of Medicine in St. Louis