Comparison of subjective outcomes between single-bundle and double-bundle anterior cruciate ligament reconstruction in patients with flat lateral tibial slope
4 affiliations
- 1Department of Orthopedic Surgery, Chang-Gung Memorial Hospital Linkou Branch, Taoyuan, Taiwan
- 2Department of Orthopedic Surgery, Chang-Gung Memorial Hospital Keelung Branch, Keelung, Taiwan
- 3Department of Orthopedic Surgery, Taoyuan General Hospital, Taoyuan, Taiwan
- 4Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan, Taiwan
Abstract
Objective:: A high lateral tibial slope (LTS) has been associated with an increased risk of graft failure and inferior subjective outcomes following anterior cruciate ligament reconstruction (ACLR), but the impact of a flat LTS remains unclear. This study aimed to compare long-term subjective outcomes of single-bundle (SB) and double-bundle (DB) ACLR in patients with a flat LTS to determine the more favorable approach.
Methods:: The study comprised 136 patients with an LTS less than 7.4 degrees who underwent SB-ACLR (64 cases) or DB-ACLR (72 cases). Lateral tibial slope was measured on preoperative magnetic resonance imaging. Patient-reported outcomes, including the University of California Los Angeles (UCLA) Activity Score, the Lysholm Knee Score, and International Knee Documentation Committee (IKDC) Score, were collected and compared between those undergoing SB- and DB-ACLR at a mean follow-up of 14.06 ± 2.98 years. Categorical and continuous variables were analyzed using chi-square and independent-samples t-tests, respectively. A P-value less than .05 was considered statistically significant.
Results:: The mean LTS was similar between the SB and DB groups (4.76 ± 1.48 vs. 4.23 ± 1.82, P = .06). The DB group had significantly better postoperative UCLA (9.32 ± 0.95 vs. 8.55 ± 1.99, P < .01), Lysholm (94.26 ± 5.61 vs. 88.23 ± 13.45, P < .01), and IKDC score (82.99 ± 4.55 vs. 77.67 ± 11.21, P < .01). Specifically, among male patients, no significant differences were found between SB and DB groups, though trends favored DB-ACLR.
Conclusion:: In patients with a flat LTS, DB-ACLR was associated with higher long-term patient-reported outcome measures than SB-ACLR; however, the clinical relevance of these differences should be interpreted with caution.
Level of Evidence:: Level III, Therapeutic study
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BibTeX
@article{yao2026comparison,
title = {{Comparison of subjective outcomes between single-bundle and double-bundle anterior cruciate ligament reconstruction in patients with flat lateral tibial slope}},
author = {Shang-Yu Yao and Keng-Yi Lin and Yi-Sheng Chan and Yu-Chieh Hung and Shih-Feng Hung and Yi-Jou Chen and Chih-Hao Chiu and Chin-Shan Ho and Cheng-Pang Yang},
journal = {Acta Orthopaedica et Traumatologica Turcica},
year = {2026},
month = sep,
doi = {10.5152/j.aott.2026.25795},
url = {https://doi.org/10.5152/j.aott.2026.25795},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Comparison of subjective outcomes between single-bundle and double-bundle anterior cruciate ligament reconstruction in patients with flat lateral tibial slope
AU - Shang-Yu Yao
AU - Keng-Yi Lin
AU - Yi-Sheng Chan
AU - Yu-Chieh Hung
AU - Shih-Feng Hung
AU - Yi-Jou Chen
AU - Chih-Hao Chiu
AU - Chin-Shan Ho
AU - Cheng-Pang Yang
PY - 2026
DA - 2026/09/10
JO - Acta Orthopaedica et Traumatologica Turcica
DO - 10.5152/j.aott.2026.25795
UR - https://doi.org/10.5152/j.aott.2026.25795
AB - Objective:: A high lateral tibial slope (LTS) has been associated with an increased risk of graft failure and inferior subjective outcomes following anterior cruciate ligament reconstruction (ACLR), but the impact of a flat LTS remains unclear. This study aimed to compare long-term subjective outcomes of single-bundle (SB) and double-bundle (DB) ACLR in patients with a flat LTS to determine the more favorable approach. Methods:: The study comprised 136 patients with an LTS less than 7.4 degrees who underwent SB-ACLR (64 cases) or DB-ACLR (72 cases). Lateral tibial slope was measured on preoperative magnetic resonance imaging. Patient-reported outcomes, including the University of California Los Angeles (UCLA) Activity Score, the Lysholm Knee Score, and International Knee Documentation Committee (IKDC) Score, were collected and compared between those undergoing SB- and DB-ACLR at a mean follow-up of 14.06 ± 2.98 years. Categorical and continuous variables were analyzed using chi-square and independent-samples t-tests, respectively. A P-value less than .05 was considered statistically significant. Results:: The mean LTS was similar between the SB and DB groups (4.76 ± 1.48 vs. 4.23 ± 1.82, P = .06). The DB group had significantly better postoperative UCLA (9.32 ± 0.95 vs. 8.55 ± 1.99, P < .01), Lysholm (94.26 ± 5.61 vs. 88.23 ± 13.45, P < .01), and IKDC score (82.99 ± 4.55 vs. 77.67 ± 11.21, P < .01). Specifically, among male patients, no significant differences were found between SB and DB groups, though trends favored DB-ACLR. Conclusion:: In patients with a flat LTS, DB-ACLR was associated with higher long-term patient-reported outcome measures than SB-ACLR; however, the clinical relevance of these differences should be interpreted with caution. Level of Evidence:: Level III, Therapeutic study
SN - 1017-995X
SN - 2589-1294
ER -