Anatomical Double-Bundle Anterior Cruciate Ligament Reconstruction: The Chinese Experience

The double-bundle (DB) anterior cruciate ligament (ACL) reconstruction has evolved gradually and got nationwide attentions in China for 13 years. This review summarizes the experiences we have achieved since the DB ACL reconstruction was started in our country in 1998, regarding choice of grafts, surgical approach, bone tunnel placement, and fixation methods. A growing number of articles reveal that DB ACL reconstruction brings better clinical outcomes regarding the results of KT-1000, pivot-shift, and Lachman tests, International Knee Documentation Committee (IKDC) outcomes, and complications. Superiority of knee stability after the DB compared with that after the single-bundle procedure was clarified by the randomized controlled trial. Currently, there is consensus in China that DB reconstruction is an attractive option when pursuing a better outcome for patients. Meanwhile, individualization is essential and cannot be ignored with respect to choice of grafts, surgical approaches, tunnel placement, and grafts fixation.