Purpose: The purpose of this study was to analyze the clinical results of anterior cruciate
ligament (ACL) reconstruction with the remnant-preserving technique by use of a hamstring
graft and looped sutures according to the amount of the tibial remnant of the ACL.
Methods: Sixteen subjects had undergone ACL reconstruction with the remnant-preserving technique
by use of 4 strands of a hamstring tendon and a looped suture technique and were followed
up for at least 12 months. The mean follow-up was 35.1 months. At the last follow-up
examination, the patients were evaluated with the International Knee Documentation
Committee scale and Hospital for Special Surgery score as subjective tests; stress
radiographs, Lachman test, and anterior drawer test by use of the KT-2000 arthrometer
(MEDmetric, San Diego, CA) as objective tests; and single-legged hop test, reproduction
of passive positioning, threshold to detection of passive motion, and single-limb
standing test as functional tests. On the basis of the extent of ACL remnant, patients
were then divided into 2 groups. Group I comprised patients with more than 20%, and
group II comprised those with less than 20%. For each of the 2 groups, a statistical
comparison of the final results was made. Results: The mean Hospital for Special Surgery score improved from 65.8 (preoperatively) to
95.2 (at last follow-up). Functional evaluation revealed that the difference was not
significant in terms of mechanical stability, but a significant difference was detected
in functional outcome and proprioception. Regarding the threshold to detection of
passive motion at 30° (P = .030) and reproduction of passive positioning at 15° (P = .032) and 30° (P = .024), group I (>20%) showed better results than group II (<20%). Conclusions: We confirmed that the remnant-preserving technique described showed good proprioceptive
and functional outcomes with statistical significance. Therefore it may be expected
that the more the tibial remnant is kept intact, the better the preservation of proprioceptive
function will be. Level of Evidence: Level IV, prognostic case series.
Key Words
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Article info
Publication history
Published online: January 30, 2008
Footnotes
The authors report no conflict of interest.
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Copyright
© 2008 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
