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Effects of Remnant Tissue Preservation on Clinical and Arthroscopic Results After Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction
- Source :
- The American journal of sports medicine. 43(8)
- Publication Year :
- 2015
-
Abstract
- Background: Clinical utility of remnant tissue preservation after single-bundle anterior cruciate ligament (ACL) reconstruction has not been established. In addition, no studies have evaluated the clinical utility of remnant preservation after anatomic double-bundle ACL reconstruction. Hypothesis: The study hypotheses were as follows: (1) Subjective and functional clinical results may be comparable between anatomic double-bundle reconstructions that preserve the remnant tissue and those that resect the remnant tissue, (2) postoperative knee stability and the second-look arthroscopic evaluation may be significantly more favorable with the remnant-preserving reconstruction, and (3) the degree of the initial graft coverage may significantly affect postoperative knee stability. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 179 patients underwent anatomic double-bundle ACL reconstruction. Based on the Crain classification of ACL remnant tissue, 81 patients underwent the remnant-preserving procedure (group P) and the remaining 98 patients underwent the remnant-resecting procedure (group R). There were no differences between the 2 groups concerning all background factors, including preoperative knee instability and intraoperative tunnel positions. The patients were followed for 2 years or more. Results: The subjective and functional clinical results were comparable between the 2 reconstruction procedures. Side-to-side anterior laxity was significantly less ( P = .0277) in group P (0.9 mm) than in group R (1.5 mm). The pivot-shift test was negative in 89% of group P and 78% of group R patients; the result for group R was significantly lower ( P = .0460). In the arthroscopic observations, results for group P were significantly better than for group R concerning postoperative laceration and fibrous tissue coverage of the grafts ( P = .0479). Conclusion: Remnant preservation in anatomic double-bundle ACL reconstruction did not significantly improve subjective and functional results in the short-term evaluation, but it significantly improved postoperative knee stability. The degree of initial graft coverage significantly affected postoperative knee stability.
- Subjects :
- Adult
Joint Instability
Male
medicine.medical_specialty
Anterior cruciate ligament reconstruction
Adolescent
Knee Joint
Anterior cruciate ligament
medicine.medical_treatment
Transplants
Physical Therapy, Sports Therapy and Rehabilitation
Lacerations
Cohort Studies
Arthroscopy
Young Adult
Double bundle
medicine
Humans
Orthopedics and Sports Medicine
Prospective Studies
Anterior Cruciate Ligament
Tissue Preservation
Anterior Cruciate Ligament Reconstruction
business.industry
Anterior Cruciate Ligament Injuries
Surgery
medicine.anatomical_structure
Remnant preservation
Second-Look Surgery
Female
business
Subjects
Details
- ISSN :
- 15523365
- Volume :
- 43
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- The American journal of sports medicine
- Accession number :
- edsair.doi.dedup.....96f25dad3adfcd4cd0074de463fe8eb2