Double-Bundle Anatomic Anterior Cruciate Ligament Reconstruction: The Technique and Clinical Experience

Anatomic double-bundle anterior cruciate ligament (ACL) reconstruction has become popular during the last 5 years. This procedure is designed to reconstruct the anatomic insertion of the ACL footprint. Previous biomechanical basic studies and clinical results have demonstrated the advantages of this procedure compared with conventional ACL reconstruction technique. Nonanatomically reconstructed double-bundle ACL surgery has been reported in the past without significant improvement of the outcome; however, the recent reports of anatomic ACL reconstruction are shown to be improving. The outcome measurement of ACL surgery is also one of the important issues to evaluate the efficacy of anatomic ACL surgery. Theoretic background, surgical technique, and instability evaluation in anatomic ACL reconstruction are discussed in this article.