Hiroshi Nakayama1, Syunichiro Kambara2, Tomoya Iseki2, Ryo Kanto2, Kenji Kurosaka2, Shinichi Yoshiya2. 1. Department of Orthopaedic Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya City, 663-8501, Hyogo, Japan. Electronic address: hiroshi0273@mac.com. 2. Department of Orthopaedic Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya City, 663-8501, Hyogo, Japan.
Abstract
BACKGROUND: To compare the early postoperative outcomes and complications of double-bundle anterior cruciate ligament (ACL) reconstruction with and without remnant preservation. METHODS: The study population comprised 125 consecutive knees that underwent double-bundle ACL reconstruction using hamstring autograft. Among the 125 knees, remnant preservation was indicated for 50 knees, while standard double-bundle reconstruction was performed in the remaining 75 knees. Postoperative evaluations included heel-height difference (HHD) at periodical follow-ups, number of knees requiring arthroscopic debridement due to problematic extension loss within six months, re-injury within one year, graft status upon second-look arthroscopy, and clinical examinations by Lysholm score and KT measurement at one year. RESULTS: All patients could be followed up for a minimum of one year after surgery. When the results obtained from both groups were compared, HHD values were significantly larger in the preservation group at three and six months, and the rate of knees requiring arthroscopic debridement was also higher in this group (12% versus 4.0%). Graft status on second-look arthroscopy was considered to be good for 92% of the knees in the preservation group versus 59% in the non-preservation group. Re-injury rates within one year were 2.0% in the preservation group and 5.3% in the non-preservation group. No significant differences in clinical examinations were found between the groups at one year. CONCLUSIONS: Remnant preservation in double-bundle hamstring autograft ACL reconstruction may enhance tissue healing; however, retention of the remnant with its full volume resulted in an increased incidence of postoperative problematic extension loss.
BACKGROUND: To compare the early postoperative outcomes and complications of double-bundle anterior cruciate ligament (ACL) reconstruction with and without remnant preservation. METHODS: The study population comprised 125 consecutive knees that underwent double-bundle ACL reconstruction using hamstring autograft. Among the 125 knees, remnant preservation was indicated for 50 knees, while standard double-bundle reconstruction was performed in the remaining 75 knees. Postoperative evaluations included heel-height difference (HHD) at periodical follow-ups, number of knees requiring arthroscopic debridement due to problematic extension loss within six months, re-injury within one year, graft status upon second-look arthroscopy, and clinical examinations by Lysholm score and KT measurement at one year. RESULTS: All patients could be followed up for a minimum of one year after surgery. When the results obtained from both groups were compared, HHD values were significantly larger in the preservation group at three and six months, and the rate of knees requiring arthroscopic debridement was also higher in this group (12% versus 4.0%). Graft status on second-look arthroscopy was considered to be good for 92% of the knees in the preservation group versus 59% in the non-preservation group. Re-injury rates within one year were 2.0% in the preservation group and 5.3% in the non-preservation group. No significant differences in clinical examinations were found between the groups at one year. CONCLUSIONS: Remnant preservation in double-bundle hamstring autograft ACL reconstruction may enhance tissue healing; however, retention of the remnant with its full volume resulted in an increased incidence of postoperative problematic extension loss.