{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T03:44:32Z","timestamp":1791517472622,"version":"4.3.4"},"reference-count":48,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["arthroscopyjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To compare the clinical and radiographic outcomes\u2014particularly the long\u2010term development of osteoarthritis\u201414\u2009years after anterior cruciate ligament (ACL) reconstruction between anatomic double\u2010bundle (DB) and anatomic single\u2010bundle (SB) techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>One hundred and five patients (33 women and 72 men; median age, 27\u2009years [range, 18\u201052\u2009years]) were randomized and underwent ACL reconstruction (DB group, n\u2009=\u200953; SB group, n\u2009=\u200952). All ACL reconstruction procedures were performed anatomically, with femoral tunnel drilling via the anteromedial portal and the use of a hamstring autograft. One blinded observer examined the patients preoperatively and at average 14\u2010year follow\u2010up. Subjective, objective, and radiographic evaluations were used to assess the outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At 14\u2010year follow\u2010up (median, 173\u2009months [range, 165\u2010187\u2009months]), 64 patients (61% overall; DB, n\u2009=\u200935 [66%]; SB, n\u2009=\u200929 [56%]) were available for final analysis. No significant differences were found between the groups in terms of the pivot\u2010shift and manual Lachman grades, KT\u20101000 arthrometer laxity measurements, single\u2010leg\u2010hop test, range of motion, Lysholm knee and Tegner activity scores, and Knee injury and Osteoarthritis Outcome Score. Minimal clinically important difference for both the sport\/recreation and quality of life subscales showed no significant difference between the groups. Correspondingly, no differences were found between the groups regarding the presence of radiographic osteoarthritis. Both groups showed significant improvement at follow\u2010up compared with preoperative data in all objective and subjective outcomes. Moreover, no significant differences were found between the SB and DB groups in Ahlb\u00e4ck grades for either the medial (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.94) or lateral (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.67) knee compartments, in Fairbank grades (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.91), or in Kellgren\u2010Lawrence grades (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.69) at the 14\u2010year follow\u2010up. The cumulative Fairbank score indicated no significant differences between the groups at the 14\u2010year follow\u2010up (SB, mean 2.7\u2009\u00b1\u20092.4; DB, mean 2.7\u2009\u00b1\u20092.3;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009= .91).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>At an average 14\u2010year follow\u2010up, the anatomic DB technique showed no clear superiority over the anatomic SB technique in terms of clinical outcomes or in the development of osteoarthritis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level II, randomized controlled trial.<\/jats:p>\n                  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