Intraoperative evaluation of the anatomical double-bundle anterior cruciate ligament reconstruction with the OrthoPilot navigation system.

The purpose of this study was to assess double-bundle anterior cruciate ligament (ACL) reconstruction, which reproduces the anteromedial bundle and posterolateral bundle, using a navigation system. In 32 patients, anteroposterior (AP) displacement and rotation of the tibia were measured before reconstruction and after posterolateral bundle fixation, anteromedial bundle fixation, and double-bundle ACL reconstruction (in posterolateral and anteromedial bundles fixation). The posterolateral bundle has an important role in the extension position, whereas the anteromedial bundle restricts AP displacement from extension to flexion. AP displacement after double-bundle ACL reconstruction was significantly improved compared to AP displacement after posterolateral bundle or anteromedial bundle fixation. Although traditional reconstruction for reproducing the anteromedial bundle is reasonable, double-bundle ACL reconstruction is recommended for improved knee stability.