[Arthroscopic anterior cruciate ligament reconstruction with remnant preserving technique].
OBJECTIVE
To evaluate the clinical outcome of arthroscopic reconstruction of anterior cruciate ligament (ACL) with remnant preserving technique.


METHODS
From May 2008 to October 2010,68 patients with ACL deficiency (33 males and 35 females, with an average age of 25.8 years, ranged from 17 to 43 years) were treated with arthroscopy. The average duration of the disease was (4.5 +/- 1.1) months. The pivot shift test showed positive results in 55 cases, Lachman test showed positive results in 68 cases, and the ADT (anterior drawer test) showed positive results in 68 cases. The anterior transition of the tibia measured by KT2000 instrument was (7.2 +/- 2.3) mm (5 to 9 mm) more than that of the opposite knee. The average Lysholm score was 55.7 +/- 5.4 (45 to 67). The average Tegner activity scores was 3.1 +/- 0.6 (2 to 4). The tibial tunnels and femoral tunnels were drilled in the middle of the footprint of the ACL, and the graft was wrapped by the remnant. Grafts were fixed with cross pin at the femoral side and with biodegradable interference screw at the tibial side. Postoperative symptoms and signs were observed in the follow-up duration. The anterior transition of the tibia was measured by KT2000, the Lysholm and Tegner scores were used to evaluate knee functions.


RESULTS
All the patients were followed up, and the duration ranged from 24 to 42 months, with a mean of (31.5 +/- 2.4) months. At the latest follow-up, there was no patients had positive result by civot shift test, while the Lachman test showed results of negative or positive of grade I, and the ADT test showed results of negative or positive of grade I or II. The anterior transition of the tibia measured by KT2000 instrument decreased to (1.9 +/- 0.7) mm (0 to 3 mm) more than that of the opposite knee (t = 21.15, P = 0.000 1). The postoperative Lysholm score 86.0 +/- 5.1(81 to 97) and Tegner score 7.8 +/- 0.3 (6 to 9) all increased compared with preoperative 55.7 +/- 5.4 and 3.1 +/- 0.6 (t = 18.55, P = 0.001 0; t = 9.11, P = 0.000 5). According to Lysholm score, excellent results were obtained in 55 cases, good in 10, poor in 3 and no bad results.


CONCLUSIONS
The ACL remnant provide vascular and nerve supply for the graft, promoting union and remodeling of grafts.
Department of Arthroscopy and Sports Medicine, Wangling Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China. arthroartist@yahoo.com.cn
Lei
L
Zhang
Zhi-Yao
ZY
Li
Jin-Song
JS
Liu
Jin
J
Sun
Jia
J
Ma
Sheng
S
Zhang
Xiao-Hua
XH
Liu
D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D008297:Male; D016896:Treatment Outcome; D055815:Young Adult