Purpose: Selective anteromedial or posterolateral bundle reconstruction is recognized as a treatment modality in partial anterior cruciate ligament (ACL) reconstruction (ACLR) with a biomechanically sufficient ACL remnant. However, there is paucity in literature investigating clinical outcomes of standard ACLR with preservation of residual continuous but biomechanically insufficient ACL tissue. The aim of this study was to investigate the influence of preservation of residual continuous but biomechanical insufficient ACL tissue in standard ACLR on complication and repeat surgery rate, and patient reported and clinical outcome.
Methods: The retrospective cohort comprised 134 patients (age 23 ± 7 years; Tegner 6 ± 3) with an isolated acute ACL tear. In 67 patients, residual continuous but biomechanically insufficient ACL tissue was present and preserved based on visual inspection, probing of the ACL tissue and Lachman test under arthroscopic view (standard reconstruction with tissue preservation; SRTP). These patients were matched to 67 patients that underwent ACLR where no residual ACL tissue could be preserved (standard reconstruction; SR) based on gender, age and chondral and/or meniscal status. Clinical failure (recurrent instability, pathological ACL graft laxity and/or ACL graft discontinuity), other complication and repeat-surgery rate within index surgery and 1-year and within index surgery and 2-year follow-up, and patient reported and clinical outcomes at 1-year and at 2-year follow-up were compared.
Results: A statistically significant lower clinical failure rate within index surgery and 1-year (SRTP, 3%; SR, 13%; P = 0.028) and within index surgery and 2-year follow-up (SRTP, 3%; SR, 23%; P = 0.001), and revision ACL surgery rate within index surgery and 1-year (SRTP, 2%; ST, 10%; P = 0.029) and within index surgery and 2-year follow-up (SRTP, 2%; SR, 18%; P = 0.001) was found in the SRTP group. No statistically significant differences were found for other investigated outcomes in patients that were without clinical failure.
Conclusion: This study shows that in ACLR surgery, preservation of residual continuous but biomechanical insufficient ACL tissue might lead to lower clinical failure rate and ACL revision surgery rate within index surgery and 1-year, and within index surgery and 2-year follow-up compared to standard ACLR where no residual continuous ACL tissue could be preserved.
Level Of Evidence: III.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00167-021-06746-x | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Suture techniques in the surgical management of flexor tendon, Achilles tendon and cruciate ligament injuries: a systematic review.
BMC Musculoskelet Disord
December 2024
Department of Orthopedics, The First Hospital of Qinhuangdao, Qinhuangdao, China.
Objective: To provide clinicians with reliable recommendations for the selection of appropriate suturing techniques for surgical management of common musculoskeletal soft tissue injuries.
Methods: A systematic search of PubMed, Springer, Web Science, Vip Database, China National Knowledge, and Wanfang Data for in vitro biomechanical studies on suture techniques in the surgical treatment of musculoskeletal soft tissue injuries covering relevant studies from April 2009 to April 2024 was performed. A generalized classification was made based on the characteristics of the techniques, and recommendations for the selection of suture techniques were made according to the GRADE concept.
A dynamic knee function scoring system for anterior cruciate ligament injuries based on normative six-degree-of-freedom gait pattern.
BMC Musculoskelet Disord
December 2024
Sports Medicine Center, West China Hospital, Sichuan University, Chengdu, China.
Background: Traditional examinations of anterior cruciate ligament (ACL) injuries focus primarily on static assessments and lack the ability to evaluate dynamic knee stability. Hence, a dynamic scoring system for knee function is needed in clinical settings. This study aimed to propose a dynamic scoring system based on a large sample of normative six-degree-of-freedom (6-DOF) knee kinematics during gait, and validate its correlation with conventional outcome measurements in assessing ACL-injured knees.
View Article and Find Full Text PDFRepair of Acute Grade-3 Combined Posterolateral Corner Avulsion Injuries Using a Transosseous Krackow Suture Pull-Through Technique.
JBJS Essent Surg Tech
December 2024
Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut.
Background: For complete disruption of the posterolateral corner (PLC) structures, operative treatment is most commonly advocated, as nonoperative treatment has higher rates of persistent lateral laxity and posttraumatic arthritis. Some studies have shown that acute direct repair results in revision rates upwards of 37% to 40% compared with 6% to 9% for initial reconstruction. In a recent study assessing the outcomes of acute repair of PLC avulsion injuries with 2 to 7 years of follow-up, patients with adequate tissue were shown to have a much lower failure rate than previously documented.
View Article and Find Full Text PDFThe modulating role of uniaxial straining in the IL-1β and TGF-β mediated inflammatory response of human primary ligamentocytes.
Front Bioeng Biotechnol
December 2024
Karl Chiari Lab for Orthopaedic Biology, Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Vienna, Austria.
Biomechanical (over-)stimulation, in addition to inflammatory and fibrotic stimuli, severely impacts the biology, contributing to the overall chronic nature of desmopathy. A major challenge has been the lack of representative two-dimensional (2D) models mimicking inflammatory processes in the presence of dynamic mechanical strain, both being crucial for ligament homeostasis. Physiological levels of strain exert anti-inflammatory effects, while excessive strain can facilitate inflammatory mechanisms.
View Article and Find Full Text PDFQuercetin attenuates the symptoms of osteoarthritis and by suppressing ferroptosis via activation of AMPK/Nrf2/Gpx4 signaling.
Mol Med Rep
March 2025
Department of Orthopedics, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing 100029, P.R. China.
Osteoarthritis (OA) is a common joint disorder involving the cartilage and other joint tissues. Quercetin (QCT) serves a protective role in the development of OA. However, to the best of our knowledge, the regulatory mechanisms of QCT in the progression of OA have not yet been fully elucidated.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!