Effect of remnant preservation on recovery of knee proprioception in arthroscopic anterior cruciate ligament reconstruction:a meta-analysis / 中国组织工程研究

ABSTRACT

BACKGROUND:Arthroscopic anterior cruciate ligament (ACL) reconstruction is the conventional surgical treatment at present for patients with severe anterior cruciate ligament injury or fracture. However, the opinions varies about whether the ACL remnant should be preserved, and its impact on the knee proprioception gets more and more attention. OBJECTIVE:To compare the influence of arthroscopic ACL reconstruction with remnant preservation or not on the proprioception of the knee joint using a meta-analysis. METHODS:We retrieved randomized control ed studies on arthroscopic ACL reconstruction with remnant preservation or not from 2001 to 2016. Meta-analysis was used to compare postoperative threshold to detection of passive motion (TTDPM), passive angle regeneration test, joint position sense and KT-1000/2000, IKDC, and Lysholm scores between remnant preservation or not. RESULTS AND CONCLUSION:(1) A total of 11 randomized control ed trials were included. (2) The meta-analysis results showed that postoperative TTDPM [OR=-0.50,95%CI(-0.74,-0.26), P<0.0001], passive angle reproduction [OR=-0.13, 95%CI(-0.26,-0.01), P=0.03<0.05] and Lysholm scores [OR=1.25, 95%CI(0.63, 2.06), P=0.0002], IKDC scores (OR=1.28, 95%CI([0.27, 2.28], P=0.01] in preserving-remnant were superior to removing-remnant for arthroscopic ACL reconstruction. However, there were no statistical y significant differences in KT1000/2000 scores [OR=-0.05, 95%CI(-0.13, 0.03), P=0.24] and joint position sense [OR=-0.30, 95%CI(-0.79, 0.18), P=0.22]. (3) In the arthroscopic ACL reconstruction, retained stump postoperative proprioception recovered wel and can obtain satisfactory clinical effect. However, prospective large-sample long-term randomized control ed trials are needed for verification.