ST/G ACL reconstruction: Double strand plus extra-articular sling vs double bundle, randomized study at 3-year follow-up

S. Zaffagnini, D. Bruni, A. Russo, Y. Takazawa, M. Lo Presti, G. Giordano, M. Marcacci

Research output: Contribution to journalArticlepeer-review


Several investigators have reported the presence of biomechanical, kinematic, anatomic, fiber orientation patterns and biological differences between the anteromedial bundle and the posterolateral bundle of ACL. The purpose of this prospective randomized study was to compare the clinical, instrumental and X-ray outcome of two ACL reconstruction techniques with hamstring tendons: one with a single intra-articular bundle associated to an extra-articular sling, the second with a more anatomic double-bundle technique that reproduces better the native ACL function. From an initial group of 100 patients who underwent ACL reconstruction, 72 patients (35 single bundle plus lateral plasty and 37 double bundle) were evaluated with IKDC, Tegner score, KT2000 arthrometer, Activity Rating Scale, Psychovitality Questionnaire and Ahlback radiographic score at a mean 3 years follow-up. Double-bundle group showed significantly better results regarding IKDC, ROM, Activity Rating Scale and time to return to sport. Also KT 2000 showed significant differences in objective stability. The double-bundle technique for ACL reconstruction described in this paper has demonstrated significantly better subjective, objective and functional results compared with a double-stranded hamstrings plus extra-articular sling at a minimum 3-year follow-up.

Original languageEnglish
Pages (from-to)573-581
Number of pages9
JournalScandinavian Journal of Medicine and Science in Sports
Issue number5
Publication statusPublished - Oct 2008


  • ACL reconstruction
  • Arthroscopy
  • Comparative study
  • Double bundle
  • Surgical technique

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation


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