Arthroscopic reconstruction of anterior cruciate ligament with preservation of the remnant bundle / 中国骨伤

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate clinical effects of arthroscopic anterior cruciate ligament (ACL) reconstruction with preservation of the remnant bundle.</p><p><b>METHODS</b>From January 2002 to December 2009, 57 patients with ACL partial rupture were treated with preservation of the remnant bundle. There were 39 males and 18 females, with an average age of 28.5 years old (ranged, 16 to 49 years old). Thirty-three patients had injuries in the left knees,and 24 patients had injuries in the right knees. Forty patients had injuries caused by sports, 7 patients had injuries caused by traffic accidents and 10 patients had injuries caused by daily sprain. The anterior drawer test showed positive results in 23 patients, weakly positive results in 6 cases; Lachman test showed positive results in 19 patients, and weakly positive in 4 patients. Both anterior drawer test and Lachman test showed positive results in 5 patients; and valgus stress test (medial) showed positive results in 24 patients. The mean value of Rolimeter measurement was 8.7 mm, (ranged, 7.5 to 11.5 mm). The mean International Knee Documentation Committee (IKDC) score was 70.0 +/- 7.5 and the Lysholm score was 68.0 +/- 6.3. The duration from injury to surgery was 1 week to 12 months,with an average of 3.1 months.</p><p><b>RESULTS</b>There were 32 patients treated with anteromedial bundle reconstruction and 25 patients treated with poterolateral bundle reconstruction. Fifty-seven patients were followed up, and the mean follow-up time was 22.5 months (ranged, 13 to 37 months). The anterior drawer test and Lachman test were all negative at 1 month post-operation. At the end of the follow-up, the range of motion of all the knees was 120 to 130 degree. There were 54 patients with negative results of anterior drawer test and Lachman test, 1 with weakly positive result of anterior drawer test and 2 with weakly positive results of Lachman test. The measurements of Rolimeter showed excellent stability of the knee. The mean IKDC score was 92.0 +/- 4.9 and the mean Lysholm score was 91.0 +/- 3.7, which all improved compared to preoperative scores.</p><p><b>CONCLUSION</b>Arthroscopic reconstruction of anterior cruciate ligament with preservation of the remnant bundle has satisfactory effects on the knee stability, which could increase the angiogenesis and collagen of the ACL and improve the proprioception of the knee.</p>