Computer-assisted anatomically placed double-bundle ACL reconstruction: an in vitro experiment with different tension angles for the AM and the PL graft.

Anterior cruciate ligament reconstruction techniques are evolving with innovations like double-bundle (DB) grafts and computer assistance. The current DB techniques do not appear to make the clinical difference yet. Insight in various techniques may lead to better results. In this study, the anterior laxity of a DB reconstruction with an anteromedial (AM) graft fixated in 90° of flexion and a posterolateral (PL) graft fixated in 20° and computer-assisted anatomically placed femoral attachments was compared to normal values and single-bundle grafts. In 8 fresh-frozen human cadaveric knees, the anterior laxity was tested from 0° to 90° flexion, with a 100Newton (N) anterior tibial load in joints with (1) intact ACL, (2) torn ACL, (3) single-bundle (SB) graft tensed with 15N in 20°, (4) anatomic AM graft tensed with 15N in 90°, (5) anatomic PL graft tensed with 15N in 20°, and (6) anatomic DB graft (4+5).