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Proprioceptive and Clinical Outcomes of Anterior Cruciate Ligament Reconstruction With Remnant Tissue Preservation Technique: A Comparison According to the Preserved Tissue Length

Proprioceptive and Clinical Outcomes of Anterior Cruciate Ligament Reconstruction With Remnant Tissue Preservation Technique: A Comparison According to the Preserved Tissue Length

Hasan Bombaci, Prof., TURKEY Bugra Basalan, MD, TURKEY Ozgul Ozturk, MD, TURKEY Onur Aydogdu, PhD, TURKEY Zübeyir Sarı, Prof, TURKEY

Marmara University, Faculty of Health Sciences, Physical Therapy and Rehabilitation Department. Yeditepe University, Faculty of Medicine, Orthopaedics and Traumatolgy Department, Istanbul, TURKEY


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Diagnosis / Condition

Treatment / Technique

Anatomic Location

Anatomic Structure

Diagnosis Method

Ligaments

ACL


Summary: Despite having similar clinical scores, preserving more remnant tissue may improve proprioceptive restoration compared to less remnant tissue preserved knee joint.


Introduction

The anterior cruciate ligament (ACL) remnant may theoretically increase ligamentization process depends on viable tissue on the remnant. However, there is no consensus in the literature regarding the effects of remnant-preserving anterior cruciate ligament reconstruction (ACLR) on clinical and proprioceptive outcomes and its superiority over the standard surgical procedure. The purpose of the present study was to compare the proprioceptive and clinical outcomes of the knee joint after ACLR with two different lengths of preserved remnant tissue.

Methods

This retrospective study included 61 patients who underwent single-bundle ACLR with remnant preservation method using hamstring autograft. We divided the participants into two groups according to the length of the remnant preserved after ACLR. Patients with accompanying ligament or meniscal injuries were excluded. Group 1 included subjects with 1/3 of the original length preserved (n=36) and group 2 included subjects with more than 1/3 of the original length preserved (n=25). Clinical outcome measures were the Tegner activity scale and the Lysholm knee scoring scale. Proprioception was evaluated with a joint position sense (JPS) test at 20°, 50°, and 70°. The contralateral limb was used as a control in this study. Independent-t-test was utilized to compare TDPM, Lysholm scores, and the Tegner activity scores between the groups.

Results

The mean age of the patients was 30.44 ± 6.92 (18 to 40) and the mean follow-up time was 2.58 ± 0.97 years. No significant differences were detected for Lysholm and Tegner scores between the groups. No differences were observed for JPS evaluation except 20° which was better in group 2 (3.34 ± 1.47) compared to group 1 (4.12 ± 1.39). The proprioceptive function of the reconstructed extremity was similar to the contralateral limb.

Conclusion

Patients who underwent remnant-preserving ACLR obtained similar clinical results regardless of the amount of preserved tissue length. However, proprioception at 20° was better restored in patients who had more than 1/3 of the original tissue preserved. Despite having similar clinical scores, preserving more remnant tissue may improve proprioceptive restoration compared to less remnant tissue preserved knee joint.


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