[Prospective study on anterior cruciate ligament reconstruction with preserving remnant anterior cruciate ligament by allograft ligament].
OBJECTIVE
To analyze the effectiveness of anterior cruciate ligament (ACL) reconstruction with preserving the remnant ACL by allograft ligament.


METHODS
Between January and July in 2008, 97 patients underwent ACL reconstruction with the allograft ligament. On the basis of the ACL's condition, patients were divided into 2 groups. In the trial group (patients having remnant ACL, n = 38), there were 27 males and 11 females with an average age of 24.3 years (range, 16-43 years); of them, 8 cases complicated by meniscus injury and 13 cases by Outbridge I degree cartilage injury; the time from injury to operation was 3-20 weeks (mean, 8.6 weeks). In the control group (patients having no remnant ACL, n = 59), there were 35 males and 24 females with an average age of 27.8 years (range, 18-48 years); of them, 16 cases complicated by meniscus injury and 23 cases by Outbridge I degree cartilage injury; the time from injury to operation was 4-44 weeks (mean, 12.7 weeks). All injuries were caused by sports in 2 groups. All patients had positive anterior drawer test and positive Lackman test. Before operation and 3, 8, 9, 15 months after operation, the function of the knee joint was evaluated by the International Knee Documentation Committee (IKDC) scale and Lysholm score. KT-2000 arthrometer was used to evaluate knee laxity.


RESULTS
All incisions healed primarily, and no intraarticular infection occurred. Thirty-seven cases and 57 cases were followed up 15 months in the trial group and the control group, respectively. Knee instability disappeared; the patients showed negative anterior drawer test and negative Lackman test. By the evaluation of KT-2000, the joint slippage of 2 groups were less than 2 mm at 3 and 6 months after operation, but it was more than 2 mm in 2 cases of the trial group and in 3 cases of the control group at 9 months after operation; and it was no change in the trial group and 2.5-4.0 mm (mean, 3.4 mm) in the control group at 15 months after operation. Both the IKDC scale and Lysholm score were higher in the trial group than in the control group 3 months after operation, but the differences were not significant (P > 0.05). Both the IKDC scale and Lysholm score were improved at 6 and 9 months after operation in 2 groups, and the trial group showed better result than the control group (P < 0.05). But at 15 months, only the Lysholm score of the trial group was significantly higher than that of the control group (P < 0.05).


CONCLUSIONS
The tibial remnant should be preserved as more as possible during the ACL reconstruction, which can decrease leakage of synovial fluid, help to heal and improve the function of knee joint.
Qi
Jie
J
Department of Orthopaedics, Shaanxi Provincial People's Hospital, Xi'an Shaanxi 710068, PR China.
Chen
Jiwu
J
Chen
Shiyi
S
Li
Yunxia
Y
Hua
Yinghui
Y
Li
Hongyun
H
Dong
Yu
Y
D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000503:physiopathology / Q000601:surgery; D008023:Ligaments, Articular / Q000637:transplantation*; D008297:Male; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D013710:Tendons / Q000601:surgery; D014184:Transplantation, Homologous; D055815:Young Adult