Bilateral Anterior Cruciate Ligament Reconstruction as a Single Procedure: Evaluation of Cost and Early Functional Results

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.