Outcome of posterior cruciate ligament reconstruction using the single- versus double bundle technique: A meta-analysis

Abstract

Objective To test the hypothesis that double bundle posterior cruciate ligament (PCL) reconstruction yields better improvement in stability and functional recovery of the knee than the single bundle technique. Methods PubMed®, Embase®, the Cochrane Library, CNKI, Wanfang and CBM disc databases were searched for comparative trials of PCL reconstruction using the single- versus double bundle technique. Data were extracted and meta-analysis was performed for stability improvement and functional recovery. Results The meta-analysis included 435 patients in three randomized controlled trials (RCTs) and eight non-RCTs. Double bundle reconstruction provided significantly better 90° posterior stability than the single bundle technique (weighted mean difference 0.81, 95% confidence interval, [CI] 0.2, 1.42). Double bundle reconstruction resulted in a significantly higher likelihood of International Knee Documentation Committee (IKDC) examination grade A than the single bundle technique (odds ratio 0.41, 95% CI 0.24, 0.72). Conclusions The small amount of data available indicates that double bundle reconstruction is superior to the single bundle technique after isolated PCL injury. These findings should be interpreted with caution due to the low quality and limited sample size of the studies concerned.