J Korean Orthop Assoc.  2019 Dec;54(6):537-546. 10.4055/jkoa.2019.54.6.537.

Clinical Results of Footprint Restoration Anterior Cruciate Ligament Reconstruction with Remnant Preservation

• Chung HM
• Seo YJ
• Song SY
• Cha M

• KMID: 2469885
• DOI: http://doi.org/10.4055/jkoa.2019.54.6.537

Abstract

PURPOSE
Anteromedial (AM), posterolateral (PL), anterior, and posterior remnant preserving anterior cruciate ligament (ACL) reconstructions were conducted on patients with partial ACL tears based on the arthroscopic findings. The clinical results of the four groups were compared.
MATERIALS AND METHODS
This study included 98 patients who underwent a remnant preserving ACL reconstruction from January 2013 to June 2016 and could be followed-up for at least two years. The subjects were categorized into four groups according to the selective bundles reconstructed: group A, anteromedial selective bundle reconstruction; group B, posterolateral selective bundle reconstruction; group C, anterior bundle reconstruction; and group D, posterior bundle reconstruction. The preoperative and postoperative anterior translation from the stress X-ray, International Knee Documentation Committee Subjective Knee Form (IKDC SKF) score, Lysholm score, and hospital for special surgery (HSS) score were compared.
RESULTS
All four groups showed significant improvement in anterior translation on the stress X-ray conducted with knees at 15° flexion, IKDC SKF score, Lysholm score, and HSS score postoperatively (in all groups, p < 0.001). No intergroup differences were observed in terms of the functional outcomes except that preoperative IKDC SKF score was higher in the C group than in the A group (p=0.021), and the preoperative Lysholm score was higher in the B group than in the A group (p=0.03).
CONCLUSION
After the AM, PL, anterior, and posterior remnant preserving ACL reconstructions, all four groups showed satisfactory results in terms of the anteroposterior stability and functional knee scores with no significant intergroup differences.

Keyword

anterior cruciate ligament; partial tear; remnant preserving; reconstruction

MeSH Terms

Anterior Cruciate Ligament Reconstruction*
Anterior Cruciate Ligament*
Humans
Knee
Tears

Figure

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  Figure 1 Schematic drawing of anterior cruciate ligament femoral attachment. We defined as anteomedial (A), as posterolateral (B), as anterior (C), and as posterior (D).

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  Figure 2 Second-look arthroscopic findings of remnant preserving anterior cruciate reconstruction. (A) The tension of posterolateral (PL) bundle was intact on arthroscopic exam. So we preserved it and selectively reconstructed anteromedial (AM)(*) bundle. (B) The tension of AM bundle was intact on arthroscopic exam. So we preserved it and selectively reconstructed PL (*) bundle. (C) The tension of posterior (Post) bundle was intact on arthroscopic exam. So we preserved it and selectively reconstructed anterior (Ant) bundle. (D) The tension of Ant bundle was intact on arthroscopic exam. So we preserved it and selectively reconstructed Post (*) bundle.

• 

  Figure 3 Second-look arthroscopic findings after (A) anteromedial selective bundle reconstruction, (B) posterolateral selective bundle reconstruction, (C) anterior selective bundle reconstruction, and (D) posterior selective bundle reconstruction. We confirmed that there was no partial tear of reconstructed anterior cruciate ligament, and the tension of reconstructed anterior cruciate ligament was intact.

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