Table 1.

Summary of in vitro biomechanical studies

Study	Femoral tunnel placement	Tibial tunnel placement	Graft material	Graft fixation angle/ Tension	Testing equipment/ Loading conditions	Graft fixation methods	Conclusion
Albuquerque et al²⁹	SB: “30° from the central position”	SB: 5 mm anterior to the medial intercondylar tubercle	SB: QT	SB: 30°/ manual	Universal Kratos® Model k5002 testing machine/ 100 N anterior force	Tibia: Bicortical screw and washer	Both the ACL reconstruction techniques are not capable of restoring intact knee stability
	DB: AMB: same as SB with a smaller diameter PLB: 2mm posterior-inferior from AMB	DB: same as SB	DB: AMB: Split QT PLB: Split QT	DB: AMB: 30°/ manual PLB: 30°/ manual		Femur: Suture and bicortical screw
Ho et al²⁵	SB: 25% and 28.5% from posterior femoral cortex and Blumensaat line respectively	SB: 44% and 43% from medial tibial cortex and anterior tibial cortex	SB: ST/ GRA	SB: 30°/ 67 N	Navigation system/ 133 N anterior force	Tibia: BioRCI biointerference screw	Both reconstruction s can equally restore joint stability
	DB: AMB: Center of AMB PLB: Center of PLB	DB: AMB: Center of AMB PLB: Center of PLB	DB: AMB: ST PLB: GRA	DB: AMB: 60°/ 67 N PLB: full extension/ 67 N		Femur: EndoButton CL	Both reconstruction s can equally restore joint stability
Mae et al²⁴	SB: 11:00/ 1:00 o’clock	SB: Center of ACL footprint	SB: ST/ GRA	SB: 20°/ 44N and 88N	Robotic simulator/ 100 N anterior & posterior force	Tibia: Custommade force gauges	Two femoral sockets ACL reconstruction provided better anteriorposterior stability compared to single femoral socket ACL reconstruction
	DB: AMB: 11:00/ 1:00 o’clock PLB: 9:30/ 2:30 o’clock	DB: same as SB	DB: AMB: ST PLB: GRA	DB: AMB: 20°/ 22N and 44N PLB: 20°/ 22N and 44N		Femur: EndoButton
Sbihi et al³²	SB: 11:00/ 1:00 o’clock	SB: Posteromedial portion of the ACL footprint	SB: ST/ GRA	SB: NI/ 50N	Rolimeter™/ maximum manual force	Tibia: Interference screw with staples	DB ACL reconstruction only resulted in a small improvement in anterior laxity compared to SB ACL reconstruction
	DB: AMB: 11:00/ 1:00 o’clock PLB: 9:30/ 2:30 o’clock	DB: AMB: 7–8 mm anterior to the PLB PLB: Anterior to anterolateral tibial spine, 7 mm anterior to PCL	DB: AMB: ST PLB: GRA	DB: AMB: 45° to 90°/ 50N PLB: 15°/ 50N		Femur: Suture and bicortical screw
Seon et al²⁷	SB: 10:30/ 1:30 o’clock	SB: Center of ACL footprint	SB: ST/ GRA	SB: Full extension/ 40N	Robotic testing system/ 134 N anterior load	Tibia: Tibial IntraFix	DB ACL reconstruction can better restore the AP laxity than SB ACL reconstruction
	DB: AMB: Center of AMB PLB: Center of PLB	DB: AMB: Center of AMB PLB: Center of PLB	DB: AMB: ST PLB: GRA	DB: AMB: 60°/ 20N PLB: Full extension/ 20N		Femur: EndoButton CL
Yagi et al²⁶	SB: 11:00/ 1:00 o’clock	SB: 5–7 mm anterior to PCL	SB: ST/ GRA	SB: 30°/ 44N	Robotic testing system/ 134 N anterior load	Tibia: Bicortical screw and washer	DB ACL reconstruction provides better rotational stability than SB ACL
	DB: AMB: Center of AMB PLB: Center of PLB	DB: same as SB	DB: AMB: ST PLB: GRA	DB: AMB: 60°/ 22N PLB: 15°/ 22N		Femur: EndoButton CL
Yamamoto et al²⁸	SB: “approximate the PL bundle of the ACL”	SB: 5–7 mm anterior to PCL	SB: ST/ GRA	SB: 30°/ 44N	Robotic testing system/ 134 N anterior load	Tibia: Spiked washer and screw	Lateralized SB ACL reconstruction is comparable to DB ACL reconstruction at low flexion angles
	DB: AMB: Center of AMB PLB: Center of PLB	DB: same as SB	DB: AMB: ST PLB: GRA	DB: AMB: 60°/ 22N PLB: 15°/ 22N		Femur: EndoButton CL

AMB, Antreomedial bundle; AP, Anterior-Posterior; BPTB, Bone-patellar tendon-Bone; DB, Double bundle ACL reconstruction; GRA, Gracilis tenson; NI, No information available; PCL, posterior cruciate ligament; PLB, Posterolateral bundle; QT, Quadriceps tendon; SB, Single bundle ACL reconstruction; ST, Semitendinosus tendon