Marx RG. Anatomic double-bundle anterior cruciate ligament reconstruction was superior to conventional single-bundle reconstruction. J Bone Joint Surg Am. 2013 Feb 20;95(4):365.

Hussein et al (senior author Dr. Freddie Fu) published a level I study in the American Journal of Sports Medicine of March 2012 showing that anatomic double-bundle ACL reconstruction was superior to anatomic single-bundle ACL reconstruction and conventional single-bundle ACL reconstruction. The study included 281 cases with 3-5 year follow up. In addition, they found that anatomic single-bundle ACL reconstruction was superior to conventional single-bundle ACL reconstruction.

Click here to view: <a href="/page/398808?o=ajax" class="highslide-ajax-link">Abstract</a>

Recently a JBJS Evidence-Based Orthopaedics commentary on this study by Dr. Robert Marx, Hospital for Special Surgery, expressed the viewpoint that anatomic double-bundle ACL reconstruction should not be used in primary cases. Dr. Marx argued that the differences found in the study were small and could not be considered clinically meaningful. This, in combination with the fact that double-bundle reconstruction includes a learning curve, increased OR time and the complexity of revision cases led him to his conclusions.

How do you view the evidence for single- versus double-bundle ACL reconstruction?