Bilateral Anterior Cruciate Ligament Reconstruction as a Single Procedure

Abstract

Background: The ideal treatment for patients presenting with bilateral anterior cruciate ligament (ACL) deficiency remains controversial.

Purpose: To evaluate cost and early functional results after bilateral ACL reconstruction at a single setting.

Study Design: Retrospective review.

Methods: Eleven patients (22 knees) who underwent bilateral ACL reconstruction at a single setting were compared with 33 patients (35 knees) who underwent unilateral ACL reconstruction during the same time period.

Results: The mean time to full unrestricted activity between groups was 6.5 months for both groups (P= 0.92). There were no significant differences between groups at latest follow-up for complication rates or laxity as judged by Lachman test, pivot shift test, and KT 1000 arthrometry. The mean International Knee Documentation Committee subjective score at a mean 3.1-year follow-up was 91.9 for the bilateral ACL group compared to 92.0 for the unilateral ACL group (P= 0.95). There was a total cost savings per knee (based on 2001 dollars) of $3751.59 when performing bilateral ACL reconstruction at a single setting (P= 0.0001).

Conclusions: For patients presenting with bilateral ACL deficient knees, reconstruction of both knees at a single setting is safe, cost effective, and does not appear to compromise early functional results.