What is Double-Bundle ACL Reconstruction & Why Is It Better?

The ACL, or Anterior Cruciate Ligament, connects the femur to the tibia in the centre of the knee joint. It is made up of two functional bundles of tissue, the anteromedial (AM) and posterolateral (PL) bundles.

The AM bundle of the ACL primarily controls anterior (forward) movement of the tibia underneath the femur. The PL bundle is critical for the rotational stability in the knee, such as in pivoting, twisting and jumping. As such, the ACL is critical to the stability of the knee during daily activities and sports that require twisting, pivoting, balancing, running and jumping.

But ACL tears are very common with over 100,000 ACL tears occuring each year in the United States. Those between 15 to 25 years old who participate in pivoting sports are most likely to experience ACL tears though ACL tears can occur at all ages.

The fibers of the ACL cannot be sewn back together again or repaired if torn. The damaged ligament must be removed and reconstructed with a new one. Double-Bundle surgery reconstructs both the AM and the PL bundles while Single-Bundle surgery only reconstructs the AM bundle.

double bundle acl reconstruction


How Long Does ACL Reconstruction Take?

It usually takes a few weeks after injury before ACL reconstruction can be performed. Also, any associated injuries to the knee joint involving cartilage or other ligaments may change how soon you can be ready for surgery. ACL reconstruction usually takes 60 to 90 minutes. The idea is to replace the torn ligament with tendon fibres, known as a tendon graft. For double bundle ACL surgery, this involves donor tendons.

Before the ACL can be surgically reconstructed, you must have these 3 criteria:

  • Your knee swelling must go down to near-normal
  • Your range-of-motion (flexion and extension) of the injured knee must be nearly equal to the uninjured knee
  • You must have good quadriceps muscle control (you should be able to do a straight-leg raise)


Why Double-Bundle ACL Surgery?

Single-Bundle ACL reconstruction does not adequately restore normal knee stability, particularly tibial rotation.

Double-Bundle reconstruction restores knee stability betterĀ compared to Single-Bundle reconstruction.

At i-Sports, we offer an even better approach to repair your torn ACL – the double-bundle reconstruction surgery.

This innovative approach provides greater anteroposterior and rotational knee stability by restoring both functional bundles of the ACL, the vertical bundle (anteromedial bundle), and the oblique bundle (posterolateral bundle).

Better Outcomes For Double Bundle ACL

While single-bundle ACL reconstruction gives good outcomes, the double-bundle technique is closer to the knee’s natural anatomy.

In single-bundle ACL reconstruction, surgery can restore anteroposterior knee stability, but is unable to restore the rotational stability of the knee joint. Another advantage is, double-bundle ACL reconstruction may slow down the rate of osteoarthritis. Double-bundle ACL reconstruction is one of the most exciting advances in orthopaedics and sports medicine.

The surgery is usually performed by an arthroscopic technique using a small camera to visualize the different anatomical structures within the knee joint. The surgeon makes small, necessary incisions at the knee without resorting to open surgery and this encourages faster recovery and less scarring.

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