BACKGROUND:Some studies have shown that the double-bundle posterior cruciate ligament reconstruction is not superior to the single-bundle posterior cruciate ligament reconstruction, and stil has some deficiencies difficult to overcome. Which is better, double-bundle reconstruction or single-bundle reconstruction? There is no uniform conclusion. OBJECTIVE:To perform a prospective cohort study on the clinical efficacy and safety of autologous single- and double-bundle posterior cruciate ligament reconstruction. METHODS:Totaly 81 patients with posterior cruciate ligament injury were randomly divided into single-bundle reconstruction group (n=41) and double-bundle reconstruction group (n=40). The knee stability, Lysholm score, Tegner score, hospital stay, operation time, fever days and number of puncture cases were compared between the two groups before and 24 months after reconstruction. RESULTS AND CONCLUSION:Compared with the single-bundle reconstruction group, the knee stability was significantly worse in the double-bundle reconstruction group (F=4.362,P=0.000); the operation time, hospital stay and number of puncture cases were also higher in the double-bundle reconstruction group (P < 0.05). At 24 months after reconstruction, the Lysholm and Tegner scores were both increased significantly in the two groups (P < 0.05), but there was no difference between the two groups (P > 0.05). These findings indicate that both single- and double-bundle reconstruction under arthroscopy is safe and effective treatment for posterior cruciate ligament injury, but the double-bundle reconstruction is not recommended as the preferred surgical procedure because of longer time and larger trauma.