Arthroscopic evaluation of preserved ligament remnant after selective anteromedial or posterolateral bundle anterior cruciate ligament reconstruction

Arthroscopy. 2012 Jun;28(6):807-17. doi: 10.1016/j.arthro.2011.11.033. Epub 2012 Feb 28.

Abstract

Purpose: The purpose of this study was to evaluate the clinical results and morphology of the preserved bundle remnants by second-look arthroscopy postoperatively 1 year after selective anteromedial (AM) or posterolateral (PL) bundle ACL reconstruction.

Methods: Between July 2004 and September 2009, 1,000 patients underwent arthroscopic anterior cruciate ligament (ACL) reconstruction at our hospital. Among them, 20 (2%) underwent selective AM bundle (group A) or PL bundle (group P) ACL reconstruction surgery with hamstring tendon autografts. At 1 year after surgery, 19 patients (7 male and 12 female patients; age range, 15 to 57 years) underwent second-look arthroscopic evaluations. The follow-up mean was 40.2 months (range, 24 to 70 months). We evaluated the results of manual knee laxity, anterior knee laxity measured by a Telos device (Telos, Marburg, Germany) at 130 N, Lysholm scores, and International Knee Documentation Committee evaluation form and performed evaluations of morphology by second-look arthroscopy.

Results: The side-to-side difference in anterior translation by use of the Telos device at 130 N was improved to 2 ± 2 mm (postoperatively) from 6 ± 2.3 mm (preoperatively) in group A and to 1.02 ± 1.26 mm from 4.93 ± 1.73 mm in group P. By second-look arthroscopy, the graft and preserved remnant of each case was considered to have acceptable synovial coverage and to be taut.

Conclusions: The preserved ACL remnants possess acceptable morphology and the functions of anterior-posterior and rotational stability after surgery. Our procedure can be recommended for surgery on partial ACL tears.

Level of evidence: Level IV, therapeutic case series.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anterior Cruciate Ligament / anatomy & histology*
  • Anterior Cruciate Ligament / surgery*
  • Arthroscopy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Orthopedic Procedures / methods*
  • Second-Look Surgery
  • Young Adult