Arthroscopic evaluation of preserved ligament remnant after selective anteromedial or posterolateral bundle anterior cruciate ligament reconstruction.

Abstract

The purpose of this study was to evaluate the clinical results and morphology of the preserved bundle remnants by second-look arthroscopy postoperatively 1 year after selective anteromedial (AM) or posterolateral (PL) bundle ACL reconstruction. Between July 2004 and September 2009, 1,000 patients underwent arthroscopic anterior cruciate ligament (ACL) reconstruction at our hospital. Among them, 20 (2%) underwent selective AM bundle (group A) or PL bundle (group P) ACL reconstruction surgery with hamstring tendon autografts. At 1 year after surgery, 19 patients (7 male and 12 female patients; age range, 15 to 57 years) underwent second-look arthroscopic evaluations. The follow-up mean was 40.2 months (range, 24 to 70 months). We evaluated the results of manual knee laxity, anterior knee laxity measured by a Telos device (Telos, Marburg, Germany) at 130 N, Lysholm scores, and International Knee Documentation Committee evaluation form and performed evaluations of morphology by second-look arthroscopy. The side-to-side difference in anterior translation by use of the Telos device at 130 N was improved to 2 ± 2 mm (postoperatively) from 6 ± 2.3 mm (preoperatively) in group A and to 1.02 ± 1.26 mm from 4.93 ± 1.73 mm in group P. By second-look arthroscopy, the graft and preserved remnant of each case was considered to have acceptable synovial coverage and to be taut. The preserved ACL remnants possess acceptable morphology and the functions of anterior-posterior and rotational stability after surgery. Our procedure can be recommended for surgery on partial ACL tears. Level IV, therapeutic case series.