A retrospective comparative study of remnant preservation and resection in double-bundle anterior cruciate ligament reconstruction using hamstring tendon grafts

Abstract

Objective To compare the remnant preservation (RP) and the remnant resection (RR) techniques in double-bundle anterior cruciate ligament (ACL) reconstruction using hamstring tendon grafts.Methods Included in this study were 62 patients with injury to the ACL double bundles who met our criteria and had been treated from May 2003 to June 2005 in our department.They were divided into an RP group (n =31) and a RR(n =31) group.There was no significant difference between the 2 groups regarding general clinical data (P ＜ 0.05).The subjective evaluations of the patients [subjective International Knee Documentation Committee(IKDC) score,Lysholm score and Cincinnati knee score] and objective ones (objective IKDC score,pivot shift test and Kneelax3 measurement) were recorded preoperatively and postoperatively and compared between the 2 groups.Results At 2 years postoperation,the average subjective IKDC score (92.3 ± 4.3 points),Lysholm score (89.0±4.5 points) and Cincinnati knee score (91.8 ±4.4 points) for the RP group were significantly better respectively than those for the RR group (88.2 ± 5.2,85.6 ± 4.9,87.2 ± 6.2points) (P ＜ 0.05).There were,however,no significant differences at 2 years postoperation between the 2 groups regarding the average objective IKDC score,pivot shift test or Kneelax3 measurement (P ＞ 0.05).The results of all the subjective and objective evaluations improved significantly at 2 years postoperation compared with preoperation in all patients (P ＜ 0.05).Conclusion Compared with the RR technique,RP technique may have a significant advantage in the subjective clinical outcomes in the double-bundle ACL reconstruction using hamstring tendon grafts,but shows no significant difference in the postoperative mechanical stability of the knee. Key words: Anterior cruciate ligament; Knee injuries; Arthroscopy; Reconstructive surgical procedures