Clinical outcomes of remnant preserving augmentation in anterior cruciate ligament reconstruction: a systematic review

Hu, Jianzhong; Qu, Jin; Xu, Danning; Zhang, Tao; Zhou, Jinyan; Lü, Hongbin

doi:10.1007/s00167-013-2749-8

Cited by 49 publications

(44 citation statements)

References 40 publications

(177 reference statements)

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“…Selective-bundle ACL reconstruction for partial tears has gained interest in the past several years. [14][15][16][17][18][19][20][21][22][23][24][25] However, clinical examination, MRI, and routine arthroscopic evaluation may not be able to provide a detailed and proper assessment of the integrity of the ACL. 11,12 As a result, determining which partial ACL tears truly involve only a single bundle continues to be a challenge.…”

Section: Discussionmentioning

confidence: 99%

The Push-Through Sign—Making the Decision for Selective-Bundle Anterior Cruciate Ligament Surgery

Bartolozzi¹,

Jog²,

Smith³

2020

Arthroscopy Techniques

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Partial anterior cruciate ligament (ACL) tears are often difficult to diagnose and treat. Recent interest in the literature has focused on performing selective-bundle ACL reconstruction in patients with symptomatic partial ACL tears when one of the ACL bundles is intact. However, the clinical examination, magnetic resonance imaging, and arthroscopic evaluation of partial ACL tears may not correlate, and proper assessment of the integrity of the intact portion of the ACL continues to be a challenge. If a selective-bundle ACL reconstruction is performed in a patient with an apparently intact but structurally damaged individual bundle, the outcome would be compromised by leaving the damaged bundle in place. This technical note provides a description of a simple and reliable arthroscopic method to aid in the diagnosis of a partial ACL tear. The use of this method to assess remaining ligamentous tissue will assist surgeons in deciding for or against selective-bundle ACL reconstruction.

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Section: Discussionmentioning

confidence: 99%

The Push-Through Sign—Making the Decision for Selective-Bundle Anterior Cruciate Ligament Surgery

Bartolozzi¹,

Jog²,

Smith³

2020

Arthroscopy Techniques

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“…Therefore, technologies providing pre-operative laxity information can help clinicians to decide whether the ACL remnants observed during surgery have any contribution to joint stability and can potentially be preserved. Further evidence regarding the long-term benefits of augmentation reconstruction surgeries needs to be generated in future studies [37].…”

Section: Anatomic Acl Reconstruction Surgerymentioning

confidence: 99%

Knee instability scores for ACL reconstruction

Rahnemai-Azar

Naendrup

Soni

et al. 2016

Curr Rev Musculoskelet Med

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Despite abundant biological, biomechanical, and clinical research, return to sport after anterior cruciate ligament (ACL) injury remains a significant challenge. Residual rotatory knee laxity has been identified as one of the factors responsible for poor functional outcome. To improve and standardize the assessment of knee instability, a variety of instability scoring systems is available. Recently, devices to objectively quantify static and dynamic clinical exams have been developed to complement traditional subjective grading systems. These devices enable an improved evaluation of knee instability and possible associated injuries. This additional information may promote the development of new treatment algorithms and allow for individualized treatment. In this review, the different subjective laxity scores as well as complementary objective measuring systems are discussed, along with an introduction of injury to an individualized treatment algorithm.

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“…Delicate debridement and bone tunnel placement are also important for reconstructing the ACL while preserving ACL remnants. Authors of some systematic reviews [6,7] and meta-analyses [8,9] have reported that patients in remnant-preserving ACL reconstruction groups do not have superior results to those in non-preserving groups. However, these systematic reviews and meta-analyses only reflect results of a small number of randomized controlled trials (RCTs).…”

Section: Introductionmentioning

confidence: 99%

Outcome Differences of Remnant- Preserving versus Non-Preserving Methods in Arthroscopic Anterior Cruciate Ligament Reconstruction: A Meta-analysis with Subgroup analysis

Won

Lee

Park

et al. 2020

Knee Surg & Relat Res

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Purpose: To analyze differences in clinical outcomes of arthroscopic anterior cruciate ligament reconstruction between remnant-preserving and non-preserving methods. Methods: International electronical databases PubMed, Embase, and the Cochrane central database from January 1966 to December 2017 were searched for randomized controlled trials (RCTs) and observational studies that compared differences of clinical outcomes of ACL reconstruction with and without remnant preservation. A metaanalysis of these studies was performed to compare clinical outcomes. Subgroup analyses were conducted to evaluate the role of methodological quality in primary meta-analysis estimates. Results: Five RCTs and six observational studies were included in this meta-analysis and subgroup analysis. The remnant-preserving method in arthroscopic ACL reconstruction showed a statistically significant difference compared to the non-preserving method regarding arthrometric evaluation (side-to-side difference). Lachman test, Lysholm scores, and IKDC subjective scores showed statistically minor difference in meta-analysis, but showed no significant difference in subgroup analysis. Remained parameters including pivot shift test, IKDC grades, incidence of cyclops lesion showed no statistically differences in meta-analysis or subgroup analysis. Conclusions: This meta-analysis with subgroup analysis showed that arthroscopic remnant-preserving ACL reconstruction provided statistically significant but limited clinical relevance in terms of arthrometric evaluation. Results of Lachman test, Lysholm scores, and IKDC subjective scores demonstrated statistically minor differences.

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Clinical outcomes of remnant preserving augmentation in anterior cruciate ligament reconstruction: a systematic review

Abstract: Systematic review, Level IV.

Cited by 49 publications

References 40 publications

The Push-Through Sign—Making the Decision for Selective-Bundle Anterior Cruciate Ligament Surgery

The Push-Through Sign—Making the Decision for Selective-Bundle Anterior Cruciate Ligament Surgery

Knee instability scores for ACL reconstruction

Outcome Differences of Remnant- Preserving versus Non-Preserving Methods in Arthroscopic Anterior Cruciate Ligament Reconstruction: A Meta-analysis with Subgroup analysis

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