Dataset Information

ACL Reconstruction Preserving the ACL Remnant Achieves Good Clinical Outcomes and Can Reduce Subsequent Graft Rupture.

ABSTRACT:

Background

Although anterior cruciate ligament (ACL) reconstruction techniques that preserve remnant tissues have been described, complete preservation may be difficult, with little known about its clinical advantages.

Purpose

To compare clinical outcomes in patients undergoing ACL reconstruction with and without ACL remnant preservation.

Study design

Case-control study.

Methods

Of 372 patients who underwent surgical treatment of an ACL injury between September 2006 and July 2010, 154 had no remaining identifiable ligament tissue and were excluded from this study. Attempts were made to preserve the ACL remnant as much as possible in the remaining 218 patients. These patients were divided into 2 groups: those in whom the remnant was preserved (group 1, n = 85) and those in whom the remnant was not preserved (group 2, n = 98). Patients were followed for at least 24 months. Outcomes, including graft rupture, were compared in the 2 groups.

Results

Time from injury to surgery was significantly shorter (7.3 ± 16.3 vs 16.0 ± 30.3 months; P < .05) and the preinjury Tegner activity was significantly higher (7.6 ± 1.4 vs 7.1 ± 1.2; P < .05; 95% confidence interval, 1.2-13.7) in group 1 than in group 2. The postoperative negative ratio of the pivot-shift test was similar in the 2 groups (87% vs 81%). Anterior stability of the knee, as measured by a KT-2000 arthrometer, was significantly better in group 1 than in group 2 (1.0 ± 0.8 vs 1.3 ± 1.0 mm; P < .05). ACL graft rupture occurred in 1 patient (1.1%) in group 1 and in 7 patients (7.1%) in group 2 (P < .05). Regression analysis showed that preservation of the remnant decreased the likelihood of graft rupture (odds ratio, 11.2; 95% confidence interval, 1.2-101.7).

Conclusion

These findings confirmed that preserving the remnant tissue of the ACL may facilitate recovery of function and decrease graft rupture after primary reconstruction.

SUBMITTER: Takazawa Y

PROVIDER: S-EPMC4555494 | biostudies-literature | 2013 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

ACL Reconstruction Preserving the ACL Remnant Achieves Good Clinical Outcomes and Can Reduce Subsequent Graft Rupture.

Takazawa Yuji Y Ikeda Hiroshi H Kawasaki Takayuki T Ishijima Muneaki M Kubota Mitsuaki M Saita Yoshitomo Y Kaneko Haruka H Kim Sung-Gon SG Kurosawa Hisashi H Kaneko Kazuo K

Orthopaedic journal of sports medicine 20130927 4

<h4>Background</h4>Although anterior cruciate ligament (ACL) reconstruction techniques that preserve remnant tissues have been described, complete preservation may be difficult, with little known about its clinical advantages.<h4>Purpose</h4>To compare clinical outcomes in patients undergoing ACL reconstruction with and without ACL remnant preservation.<h4>Study design</h4>Case-control study.<h4>Methods</h4>Of 372 patients who underwent surgical treatment of an ACL injury between September 2006 ...[more]

PMID: 26535246

Similar Datasets

Project description:BackgroundThe risk of sustaining a graft rupture after anterior cruciate ligament reconstruction (ACLR) is high. Contributing risk factors are, however, still not clearly identified.ObjectiveThe aim of this systematic review was to identify and quantify risk factors for graft rupture after ACLR.MethodsA systematic review with meta-analysis (PROSPERO CRD42020140129) based on PRISMA guidelines was performed. MEDLINE, CINAHL and EMBASE were searched from inception to September 2021. Prospective and retrospective studies addressing risk factors for graft rupture after ACLR in males/females of all ages were considered. Meta-analyses using a random effect model (effect measure: odds ratio [OR] with 95% confidence interval [CI]) were performed. The GRADE tool was used to assess evidence quality.ResultsFollowing full-text screening of 310 relevant papers, 117 were eventually included, incorporating up to 133,000 individuals in each meta-analysis. Higher Tegner activity level (≥ 7 vs < 7) at primary injury (OR 3.91, 95% CI 1.69-9.04), increased tibial slope (degrees) (OR 2.21, 95% CI 1.26-3.86), lower psychological readiness to return to sport (RTS) (OR 2.18, 95% CI 1.32-3.61), early surgery (< 12 vs ≥ 12 months) (OR 1.87, 95% CI 1.58-2.22), RTS (pre-injury level) (OR 1.87, 95% CI 1.21-2.91) and family history of ACL injury (OR 1.76, 95% CI 1.34-2.31) were all associated with increased odds of graft rupture. Higher age (OR 0.47, 95% CI 0.39-0.59), female sex (OR 0.88, 95% CI 0.79-0.98), fewer self-reported knee symptoms pre-reconstruction (OR 0.81, 95% CI 0.69-0.95) and concomitant cartilage injuries (OR 0.70, 95% CI 0.62-0.79) instead decreased the odds. Meta-analysis revealed no association between body mass index, smoking, joint laxity, RTS time, knee kinematics, muscle strength or hop performance and graft rupture.ConclusionConspicuous risk factors for graft rupture were mainly sports and hereditary related. Few studies investigated function-related modifiable factors or included sports exposure data.

Dataset Information

ACL Reconstruction Preserving the ACL Remnant Achieves Good Clinical Outcomes and Can Reduce Subsequent Graft Rupture.

Background

Purpose

Study design

Methods

Results

Conclusion

Publications

ACL Reconstruction Preserving the ACL Remnant Achieves Good Clinical Outcomes and Can Reduce Subsequent Graft Rupture.

Similar Datasets

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