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Two for One: Doing Both ACL Surgeries at the Same Time

The anterior cruciate ligament (ACL) in the knee is commonly injured. When it is torn completely, it must be surgically reconstructed. Most ACL patients have only one bad knee. But in up to four percent of cases, both knees have torn ACLs. Then the surgeon and the patient have a decision to make. Operate on one knee at a time (called unilateral ACL reconstruction)? Or reconstruct both ACLs during the same surgery ( bilateral ACL reconstruction)?

This study looked at the costs and early results of doing bilateral ACL surgery. Eleven patients who got bilateral surgery were compared to 33 patients who had ACL surgery on just one knee. All patients had the same rehab protocol. The patients were followed for two to three years.

The results looked equally good for both types of surgery. Both groups went back to regular activity about six months after surgery. There were no major complications in either group. Both groups had strong, stable knees after ACL reconstruction.

The cost analysis of bilateral surgery showed a large costs savings to patients with injured ACLs in both knees. Doing bilateral surgery cost 7,500 dollars less for each patient. Most of the cost savings was in operating room expenses. The authors conclude that bilateral ACL reconstruction is safe, effective, and economical.

References: Christopher M. Larson, MD, et al. Bilateral Anterior Cruciate Ligament Reconstruction as a Single Procedure: Evaluation of Cost and Early Functional Results. In The American Journal of Sports Medicine. January/February 2004. Vol. 32. No. 1. Pp. 197-200.

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