Single- versus bi-socket anterior cruciate ligament reconstruction using autogenous multiple-stranded hamstring tendons with EndoButton femoral fixation: A prospective study

Purpose: This prospective study was conducted to compare the single-socket and the bi-socket anterior cruciate ligament (ACL) reconstruction technique s in terms of outcome. Type of Study: Nonrandomized control trial. Methods: There were 160 consecutive patients with unilateral chronic ACL insufficie ncy who underwent endoscopic single- or bi-socket ACL reconstruction altern ately using multiple-stranded medial hamstring tendon and EndoButton (Smith & Nephew, Andover, MD) femoral fixation. All patients underwent the same p ostoperative rehabilitation protocol. Of them, 106 patients (57 single, 49 bi) were available for 2-year follow-up. Results: According to the IKDC Kne e Ligament Evaluation Form, 23 patients (40%) of the single-socket group we re subjectively graded as normal, 30 (53%) as nearly normal, and 4 (7%) as abnormal. Twenty-six patients (53%) of the bi-socket group were graded as n ormal, 21 (43%) as nearly normal, and 2 (4%) as abnormal (P = .19). The mea n side-to-side anterior laxity difference (KT-1000 manual maximum force) wa s 0.9 +/- 1.8 mm for the single-socket group and 0.7 +/- 1.2 nun for the bi -socket group (P = .44). Fifty-three of 57 patients (93%) in the single-soc ket group and all patients in the bi-socket group showed anterior laxity di fferences of +/-3 nun or less (P = .12). There were no differences in thigh muscle strength between the groups. Conclusions: Both single- and bi-socke t ACL reconstruction using autogenous multiple-stranded hamstring tendons w ith EndoButton fixation provided satisfactory anterior stability, and there were no statistically significant differences in subjective results or mea sured restored stability between the 2 groups.