Long term results after double and single bundle ACL reconstruction: Is there any difference? A meta - analysis of randomized controlled trials
Objective: The double-bundle (DB) techniques are considered to yield better stability of the knee compared with single-bundle (SB) for anterior cruciate ligament (ACL) reconstruction. However, most studies followed up patients in short to middle-term within 5 years, and the longer-term efficacy of S...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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AVES
2019-03-01
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| Series: | Acta Orthopaedica et Traumatologica Turcica |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1017995X18303158 |
| _version_ | 1797912571635826688 |
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| author | Zhenyue Dong Yingzhen Niu Jianchao Qi Yifan Song Fei Wang |
| author_facet | Zhenyue Dong Yingzhen Niu Jianchao Qi Yifan Song Fei Wang |
| author_sort | Zhenyue Dong |
| collection | DOAJ |
| description | Objective: The double-bundle (DB) techniques are considered to yield better stability of the knee compared with single-bundle (SB) for anterior cruciate ligament (ACL) reconstruction. However, most studies followed up patients in short to middle-term within 5 years, and the longer-term efficacy of SB and DB ACL reconstruction is still beyond consensus. The purpose of this meta-analysis is to compare the longer-term efficacy between double-bundle (DB) and single-bundle (SB) techniques. Methods: PubMed, EMBASE, and Cochrane Library databases were searched for relevant articles published up to November, 2017 with an English language restriction. The searches were limited to human subjects and randomized controlled trials (RCTs). In addition, the reference lists of identified articles were checked manually to avoid missing other potentially eligible studies. This process was performed iteratively until no additional articles could be included. The quality of the included studies was assessed using The Cochrane Collaboration's risk of bias tool. All statistical analyses were performed with Review Manager soft-ware. Results: A total of five RCTs involving 294 patients were included finally. No studies were excluded due to insufficient data or low quality. The pooled results showed no statistically significant difference between SB and double bundle DB reconstructions for Lysholm, IKDC, pivot shift, KT scores, and the development of osteoarthritis at a minimum of 5 years. No significant heterogeneity was found across all outcomes. Conclusion: The best available evidence demonstrated that SB and DB techniques could yield similar efficacy for ACL reconstruction. And no superiority was founded in DB ACL reconstruction with a minimal 5-year follow-up. Given that, the relatively simple and proven techniques of SB ACL reconstruction may be preferable for orthopedic surgeons.Level of evidence: Level I, Therapeutic Study. Keywords: Anterior cruciate ligament, Reconstruction, Single bundle, Double bundle |
| first_indexed | 2024-04-10T11:57:57Z |
| format | Article |
| id | doaj.art-362976869e3749ed95bbfc05bcd018fc |
| institution | Directory Open Access Journal |
| issn | 1017-995X |
| language | English |
| last_indexed | 2024-04-10T11:57:57Z |
| publishDate | 2019-03-01 |
| publisher | AVES |
| record_format | Article |
| series | Acta Orthopaedica et Traumatologica Turcica |
| spelling | doaj.art-362976869e3749ed95bbfc05bcd018fc2023-02-15T16:16:44ZengAVESActa Orthopaedica et Traumatologica Turcica1017-995X2019-03-015329299Long term results after double and single bundle ACL reconstruction: Is there any difference? A meta - analysis of randomized controlled trialsZhenyue Dong0Yingzhen Niu1Jianchao Qi2Yifan Song3Fei Wang4Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, ChinaDepartment of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, ChinaDepartment of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, ChinaDepartment of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, ChinaCorresponding author. Fax: +86 311 88602613.; Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, ChinaObjective: The double-bundle (DB) techniques are considered to yield better stability of the knee compared with single-bundle (SB) for anterior cruciate ligament (ACL) reconstruction. However, most studies followed up patients in short to middle-term within 5 years, and the longer-term efficacy of SB and DB ACL reconstruction is still beyond consensus. The purpose of this meta-analysis is to compare the longer-term efficacy between double-bundle (DB) and single-bundle (SB) techniques. Methods: PubMed, EMBASE, and Cochrane Library databases were searched for relevant articles published up to November, 2017 with an English language restriction. The searches were limited to human subjects and randomized controlled trials (RCTs). In addition, the reference lists of identified articles were checked manually to avoid missing other potentially eligible studies. This process was performed iteratively until no additional articles could be included. The quality of the included studies was assessed using The Cochrane Collaboration's risk of bias tool. All statistical analyses were performed with Review Manager soft-ware. Results: A total of five RCTs involving 294 patients were included finally. No studies were excluded due to insufficient data or low quality. The pooled results showed no statistically significant difference between SB and double bundle DB reconstructions for Lysholm, IKDC, pivot shift, KT scores, and the development of osteoarthritis at a minimum of 5 years. No significant heterogeneity was found across all outcomes. Conclusion: The best available evidence demonstrated that SB and DB techniques could yield similar efficacy for ACL reconstruction. And no superiority was founded in DB ACL reconstruction with a minimal 5-year follow-up. Given that, the relatively simple and proven techniques of SB ACL reconstruction may be preferable for orthopedic surgeons.Level of evidence: Level I, Therapeutic Study. Keywords: Anterior cruciate ligament, Reconstruction, Single bundle, Double bundlehttp://www.sciencedirect.com/science/article/pii/S1017995X18303158 |
| spellingShingle | Zhenyue Dong Yingzhen Niu Jianchao Qi Yifan Song Fei Wang Long term results after double and single bundle ACL reconstruction: Is there any difference? A meta - analysis of randomized controlled trials Acta Orthopaedica et Traumatologica Turcica |
| title | Long term results after double and single bundle ACL reconstruction: Is there any difference? A meta - analysis of randomized controlled trials |
| title_full | Long term results after double and single bundle ACL reconstruction: Is there any difference? A meta - analysis of randomized controlled trials |
| title_fullStr | Long term results after double and single bundle ACL reconstruction: Is there any difference? A meta - analysis of randomized controlled trials |
| title_full_unstemmed | Long term results after double and single bundle ACL reconstruction: Is there any difference? A meta - analysis of randomized controlled trials |
| title_short | Long term results after double and single bundle ACL reconstruction: Is there any difference? A meta - analysis of randomized controlled trials |
| title_sort | long term results after double and single bundle acl reconstruction is there any difference a meta analysis of randomized controlled trials |
| url | http://www.sciencedirect.com/science/article/pii/S1017995X18303158 |
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