Arthroscopic anterior cruciate ligament reconstruction with remnant preservation: a prospective comparison study

Abstract

To evaluate the clinical significance of arthroscopic anterior cruciate ligament (ACL) reconstruction using the remnant-preserved technique. From August 2008 to September 2009, 70 cases with the remnant of injured ACL were included in the trials, which were randomized into the remnant preservation (RP) group and the control group, 35 cases in each group. All patients in the two groups underwent arthroscopic ACL reconstruction surgeries, with ACL-remnant preserving technique in RP group and ACL-remnant resection in control group, respectively. The injured ACL was reconstructed with allograft in all cases. Postoperative follow-up assessment included the International Knee Documentation Committee (IKDC) grading and Lysholm score, Lachman test, pivot shift test and KT-1000 measurement, proprioception measurements and the arthroscopic second look evaluation. Sixty-one (61/70, 87%) cases were available for an average of 13.1 months follow-up assessment postoperatively. There were no significant differences between the RP and control group in functional outcome as evaluated with Lysholm score (96.4 vs. 94.9, P = 0.71) and IKDC grading (cases with A and B gradings: 30 vs. 29, P = 0.586). Regarding objective stability, there were no differences between the 2 group in mean side-to-side difference of KT-1000 (1.69 mm vs. 1.65 mm, P = 0.83), Lachman test (negative cases: 29 vs. 28, P = 1.00) and pivot shift test (negative cases: 31 vs. 27, P = 0.225). There was also no difference between the groups in proprioception evaluation measured with angle repetitive test (4.56° vs. 4.28°, P = 0.522). During second look arthroscopic examination, the grafts synovial coverage rates were found to be 85% in the RP group and 84.2% in the control group, without significant difference (P > 0.05). Arthroscopic ACL reconstruction with the remnant preserving technique using tendon allograft do not improve the postoperative knee-joint function scores, stability, proprioception and synovial coverage of grafts.