Can the pivot-shift be eliminated by anatomic double-bundle anterior cruciate ligament reconstruction?

Purpose: To assess the ability of anatomic double-bundle anterior cruciate ligament reconstruction in eliminating the pivot-shift phenomenon when identified by a quantitative measuring system (computer navigation or magnetic resonance imaging). Methods: Literature review. Medline, Google Scholar and Cochrane Reviews computerized databases research using the keywords 'pivot-shift,' 'anterior cruciate ligament reconstruction' and 'double bundle.' Twelve (7 in vitro and 5 in vivo) studies met the inclusion criteria. Results: There was a wide variation in the absolute value of translation and rotation measured after anatomic double-bundle anterior cruciate ligament reconstruction. There were also differences in fixation methods, pivot-shift execution conditions, applied stresses during the pivot-shift, calculation methods and reference systems utilized by measurement systems. Conclusions: The double-bundle reconstruction was shown to over-constrain the knee with respect to the intact value, especially closer to knee extension. This review demonstrated that anatomic double-bundle anterior cruciate ligament reconstruction is able to eliminate pathological translations and rotations during the pivot-shift phenomenon, as identified by quantitative measurement systems. Level of evidence: Review of Level III studies, Level III. [ABSTRACT FROM AUTHOR]