title: Comparison of clinical results according to amount of preserved remnant in arthroscopic anterior cruciate ligament reconstruction using quadrupled hamstring graft.
abstract: OBJECTIVE
  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 degrees (P = .030) and reproduction of passive positioning at 15 degrees (P = .032) and 30 degrees (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.
  
  
  METHODS
  Level IV, prognostic case series.
authors.affiliation: Department of Orthopedic Surgery, Soonchunhyang University Hospital, Seoul, South Korea. bilee@hosp.sch.ac.kr
authors.forename: Byung-Ill
authors.initials: BI
authors.lastname: Lee
authors.forename: Sai-Won
authors.initials: SW
authors.lastname: Kwon
authors.forename: Jun-Bum
authors.initials: JB
authors.lastname: Kim
authors.forename: Hyung-Suk
authors.initials: HS
authors.lastname: Choi
authors.forename: Kyung-Dae
authors.initials: KD
authors.lastname: Min
mesh_terms: D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011434:Proprioception; D019651:Plastic Surgery Procedures / Q000379:methods*; D013536:Suture Techniques; D013710:Tendons / Q000473:pathology / Q000637:transplantation*; D016896:Treatment Outcome