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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 9/2013

01-09-2013 | Knee

Roles of ACL remnants in knee stability

Authors: Junsuke Nakase, Tatsuhiro Toratani, Masahiro Kosaka, Yoshinori Ohashi, Hiroyuki Tsuchiya

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 9/2013

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Abstract

Purpose

This study evaluated knee laxity in anterior tibial translation and rotation following removal of anterior cruciate ligament (ACL) remnants using a computer navigation system.

Methods

This prospective study included 50 knees undergoing primary ACL reconstruction using a navigation system. ACL remnants were classified into four morphologic types: Type 1, bridging between the roof of the intercondylar notch and tibia; Type 2, bridging between the posterior cruciate ligament and tibia; Type 3, bridging between the anatomical insertions of the ACL on the lateral wall of the femoral condyle and the tibia; and Type 4, no bridging of ACL remnants. Anterior tibial translation and rotatory laxity were measured before and after remnant resection using a navigation system at 30°, 60°, and 90° of knee flexion. The amount of change in anterior tibial translation and rotatory laxity of each type was compared among the types.

Results

The different morphologic types of ACL remnants were as follows: Type 1, 15 knees; Type 2, 9 knees; Type 3, 6 knees; and Type 4, 20 knees. The amount of change in anterior tibial translation and rotatory laxity at 30° knee flexion in Type 3 was significantly larger than in the other types. There were no significant differences in either tibial translation or rotatory laxity at 60° and 90° knee flexion among the types.

Conclusions

In Type 3, ACL remnants contributed to anteroposterior and rotatory knee laxity evaluated at 30° knee flexion. The bridging point of the remnants is important to knee laxity. The Type 3 remnant should be preserved as much as possible when ACL reconstruction surgery is performed.

Level of evidence

Prognostic study, Level II.
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Metadata
Title
Roles of ACL remnants in knee stability
Authors
Junsuke Nakase
Tatsuhiro Toratani
Masahiro Kosaka
Yoshinori Ohashi
Hiroyuki Tsuchiya
Publication date
01-09-2013
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 9/2013
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-012-2260-7

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