No difference found in the magnetic resonance imaging signal intensity of the anterior cruciate ligament reconstruction graft between single-bundle anterior cruciate ligament reconstruction with concomitant anterolateral ligament surgery and double-bundle anterior cruciate ligament reconstruction.

Purpose: The purpose is to investigate whether the graft of single-bundle anterior cruciate ligament reconstruction with concomitant anterolateral ligament surgery (SBACLR-ALLR) has a healing advantage over that of double-bundle ACLR (DBACLR). It is hypothesised that there is no difference in the signal-to-noise quotient (SNQ) of the ACLR graft between SBACLR-ALLR and DBACLR. Methods: A retrospective case-control study was conducted from 2010 to 2019, comparing patients who received SBACLR-ALLR and DBACLR. The primary outcome was the SNQ of the ACLR graft. The secondary outcomes were the clinical results assessed at 2 years postoperation. Results: Forty-eight SBACLR-ALLRs and sixty DBACLRs with a mean follow-up of 53 months were identified. The SNQ of the ACLR graft in SBACLR-ALLR was comparable to that in DBACLR (6.9 ± 5.3 and 6.4 ± 5.0, respectively; Conclusion: When comparing SBACLR-ALLR and DBACLR, no difference was found in the postoperative SNQ, the 2-year graft rupture rate, the rate of return to sport, the proportion of patients achieving MCID in IKDC at 2-year follow-up, and the 2-year clinical outcomes. These results suggest that adding an ALLR to SBACLR yields outcomes comparable to the more technically demanding DBACLR. Level of Evidence: Level III.