Summary

Often in ACL traumatology the intact bundle is sacrificed to allow easier reconstruction especially in a population of sports patients. The aim of this study is to compare clinical and imaging results of two ACL reconstruction techniques in the presence of an intact AM bundle: the first option by sacrificing it while the second one involves its preservation by exploiting its biological potential.

Abstract

Introduction

AND PURPOSE:
Several methods outlined in literature for the management of chronic partial Anterior Cruciate Ligaments Tears did not preserve the undamaged section of the ligament. The purpose of this research was to conduct a retrospective analysis of the outcomes achieved using the identical ACL reconstructive surgery method in 43 sports patients, whether the AM bundle was preserved or not.
MATERIAL & METHODS
Between 2018 and 2021, 43 patients with ACL partial tear injury and rupture of the posterolateral (PL) bundle were randomly split into 2 groups with similar sex, age, and sports activity levels. Group A, consisting of 22 patients, underwent ACL reconstruction utilizing the ST-GR over the top technique, which involved sacrificing the anteromedial (AM) remaining bundle. Meanwhile, in Group B, 21 patients underwent ACL reconstruction technique with the use of only ST bundle technique and preserving the AM bundle.
Each patient underwent MRI assessment at 12 months and clinical evaluation using the IKDC and Tegner scores at 6-, 12-, 24-, 36-, 48-months. Testing with the KT-1000 device was conducted at 12 months follow-up. Statistical analysis was conducted on the results to compare subjective outcome and stability between the 2 groups, with significance set at P < 0.05 for all tests.

Results

No failures were noted. At final follow-up IKDC subjective score was 90.6±3.7 in group A and 91.2±3.4 in group B. At 48-month follow-up, group A had a Tegner score of 7.4±2.3, while group B had a score of 7.8±1.7. KT-1000 results show that group A had a 1.3±0.9 mm side-to-side difference compared to group B's 0.9±0.6 mm. Group A took 7.1 months to return to the sport, while Group B took 6.2 months.

Conclusions

Both methods described in this study have proven to ensure a successful result. Otherwise notable advantages were observed with the sparing bundle technique in group B, including improved clinical scores at final follow-up and especially a faster resumption of sporting activities