Single-Bundle versus Double-Bundle Posterior Cruciate Ligament Reconstruction: A Meta-Analysis of Randomized Controlled Trials

PURPOSE: This meta-analysis evaluated the benefits of single-bundle (SB) and double-bundle (DB) surgical techniques for posterior cruciate ligament reconstruction (PCLR) in terms of clinical outcomes. METHODS: Five electronic databases were searched for relevant articles published until September 2016. Clinical outcomes of both techniques were evaluated using Lysholm knee function scores, Tegner activity scores, side-to-side differences, and International Knee Documentation Committee (IKDC) objective grades. The results are presented as a risk ratio (RR) for binary outcomes and a weighted mean difference (WMD) for continuous outcomes with a 95% confidence interval (CI). RESULTS: Four randomized controlled trials (RCTs) were included. There were no significant differences in the Lysholm knee function scores (WMD=1.63; 95% CI, 0.00 to 3.27; I(2)=0%), Tegner activity scores (WMD=0.17; 95% CI, −0.08 to 0.43; I(2)=20%), side-to-side differences (WMD=−0.97; 95% CI, −2.41 to 0.47; I(2)=78%), and IKDC objective grades (RR=1.18; 95% CI, 1.00 to 1.39; I(2)=0%) at the final follow-up. CONCLUSIONS: The present study demonstrates that both SB and DB techniques for PCLR are comparable in terms of restoration of knee stability and improvement of knee function. However, it is still unclear which technique yields better clinical outcomes. To verify and further corroborate our results, more larger-scale, high-quality RCTs are encouraged.