Mechanical behavior of single-bundle versus double-bundle anterior cruciate ligament repair with a single tibial tunnel

Objetive: To use finite elements simulation to determine the mechanical differences of the femoral tunnel in monofascicular and bifascicular anterior cruciate ligament (ACL) repair with a single tibial tunnel. Material and method: A finite elements study was made of the tension experienced in the fixation material (Endobutton (R) and Endobutton direct (R)) and bone component in monofascicular and bifascicular ACL repair with a single tibial tunnel. Resistance to compression of the distal extremity of the femur was simulated after creating the tunnels. Results: The forces experienced by the fixation material and bone component were within the limits of tolerance of both materials in all the studied scenarios, in both the anchoring zone and in the distal femur. Conclusions: The creation of an increased number of tunnels in ACL reconstruction does not imply a risk of material rupture or bone fracture.