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Knee Surgery, Sports Traumatology, Arthroscopy

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Open Access 01-11-2021 | KNEE

Remnant preservation provides good clinical outcomes after anterior cruciate ligament reconstruction

Authors: Hui Huang, Masashi Nagao, Hirofumi Nishio, Haruka Kaneko, Yoshitomo Saita, Yuji Takazawa, Hiroshi Ikeda, Kazuo Kaneko, Muneaki Ishijima

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 11/2021

Abstract

Purpose

To evaluate the association of remnant preservation (RP) and non-RP (NRP) with patient-reported outcome measures and subsequent graft rupture at a minimum 2-year follow-up after anterior cruciate ligament (ACL) reconstruction.

Methods

Patients in this retrospective study underwent primary isolated ACL reconstruction by the RP or NRP technique with a four- to five-strand hamstring tendon graft. Multivariate linear or logistic regression and Cox regression analyses were performed to compare the physical and psychological outcomes by the International Knee Documentation Committee subjective knee form (IKDC-SKF) and the Japanese Anterior Cruciate Ligament questionnaire 25 (JACL-25), respectively; satisfaction rate; and prognosticators of graft rupture.

Results

In total, 120 patients (mean age, 30.6 ± 12.7 years; 54 RP, 66 NRP) with a mean follow-up of 3.2 ± 1.6 years were enrolled in this study. At the latest postoperative follow-up, the RP group showed a mean IKDC-SKF score of 92.3 ± 8.5 and mean JACL-25 score of 13.2 ± 11.2, while these scores in the NRP group were 86.4 ± 12.2 and 24.4 ± 19.5, respectively (P = 0.016 and 0.007, respectively). No significant differences were found in the return-to-sports rate (RP vs. NRP, 79.5% vs. 67.5%) or satisfaction rate (RP vs. NRP, 89.2% vs. 74.4%) (n.s.); however, a significant difference was found in the rate of return to the preinjury sports level (RP vs. NRP, 64.1% vs. 37.5%; P = 0.014). The graft rupture rate was significantly higher in the NRP than RP group (9/66 vs. 1/54; hazard ratio 9.29; 95% confidence interval 1.04–82.81). Younger age (≤ 18 years) was the other important risk factor for graft rupture (hazard ratio 8.67; 95% confidence interval 2.02–37.13).

Conclusion

Patients who underwent ACL reconstruction with the RP technique obtained somewhat better physical and psychological results than those who underwent ACL reconstruction with the NRP technique. With respect to clinical relevance, patients treated with the RP technique may obtain better outcomes in terms of graft rupture and return to the preinjury sports level than those treated with the NRP technique, but with no differences in overall return to sports or satisfaction.

Level of evidence

IV.

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Title: Remnant preservation provides good clinical outcomes after anterior cruciate ligament reconstruction
Authors: Hui Huang
Masashi Nagao
Hirofumi Nishio
Haruka Kaneko
Yoshitomo Saita
Yuji Takazawa
Hiroshi Ikeda
Kazuo Kaneko
Muneaki Ishijima
Publication date: 01-11-2021
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 11/2021
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-020-06406-6

At a glance: The STEP trials

Springer Medicine

Remnant preservation provides good clinical outcomes after anterior cruciate ligament reconstruction

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

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