title: Roles of ACL remnants in knee stability.
abstract: OBJECTIVE
  This study evaluated knee laxity in anterior tibial translation and rotation following removal of anterior cruciate ligament (ACL) remnants using a computer navigation system.
  
  
  METHODS
  This prospective study included 50 knees undergoing primary ACL reconstruction using a navigation system. ACL remnants were classified into four morphologic types: Type 1, bridging between the roof of the intercondylar notch and tibia; Type 2, bridging between the posterior cruciate ligament and tibia; Type 3, bridging between the anatomical insertions of the ACL on the lateral wall of the femoral condyle and the tibia; and Type 4, no bridging of ACL remnants. Anterior tibial translation and rotatory laxity were measured before and after remnant resection using a navigation system at 30°, 60°, and 90° of knee flexion. The amount of change in anterior tibial translation and rotatory laxity of each type was compared among the types.
  
  
  RESULTS
  The different morphologic types of ACL remnants were as follows: Type 1, 15 knees; Type 2, 9 knees; Type 3, 6 knees; and Type 4, 20 knees. The amount of change in anterior tibial translation and rotatory laxity at 30° knee flexion in Type 3 was significantly larger than in the other types. There were no significant differences in either tibial translation or rotatory laxity at 60° and 90° knee flexion among the types.
  
  
  CONCLUSIONS
  In Type 3, ACL remnants contributed to anteroposterior and rotatory knee laxity evaluated at 30° knee flexion. The bridging point of the remnants is important to knee laxity. The Type 3 remnant should be preserved as much as possible when ACL reconstruction surgery is performed.
  
  
  METHODS
  Prognostic study, level II.
authors.affiliation: Department of Orthopaedic Surgery, School of Medicine, Kanazawa University, 13-1 Takaramachi, Kanazawa, 920-0934, Japan. nakase1007@yahoo.co.jp
authors.forename: Junsuke
authors.initials: J
authors.lastname: Nakase
authors.forename: Tatsuhiro
authors.initials: T
authors.lastname: Toratani
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kosaka
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Ohashi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tsuchiya
mesh_terms: D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction; D053587:Arthrometry, Articular; D001182:Arthroscopy; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis*; D007719:Knee Joint; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D025321:Surgery, Computer-Assisted; D055815:Young Adult