Effects of single-bundle and double-bundle ACL reconstruction on tibiofemoral compressive stresses and joint kinematics during simulated squatting

The purpose of this study was to compare tibiofemoral (TF) kinematics and TF compressive stresses between single bundle- (SB-) and double bundle-ACL reconstruction (DB-ACLR) during simulated squatting. Twelve matched pairs of fresh frozen cadaver knees were utilized. A simulated squat through 100° of knee flexion was performed in the ACL-intact joint. The ACL was transected and SB- and DB-ACLR procedures were performed in one knee of each pair. The squat was repeated. Knee kinematics were measured using a motion tracking system and the TF compressive forces were measured using thin film pressure sensors. The posterior shifts of the tibia for SB- and DB-ACLR knees were significantly greater than the ACL-intact condition for knee flexion angles 0° to 40° (p < .05). However, there was no difference between the SB- and DB-ACLR knees at any flexion angle (0° to 100°; p = .37). SB- and DB-ACLR knees had greater IE rotation than intact knees from 90° through 50° of flexion (p < .05), but not between 40° and full extension. There was no difference between SB- and DB-ACLR knees (p = .68). The TF compressive stresses of the DB-ACLR were significantly lower than intact for all angles except 10° (p = .06), whereas SB-ACLR knees did not differ from intact at flexion angles between 30° and 50° (p > .32). There were no significant differences between the two reconstruction conditions (p = .74). This study showed that there was no difference in the TF kinematics or compressive stresses between SB- and DB-ACLR, and only minor differences when compared to the intact state.