Remnant preserving anterior cruciate ligament reconstruction: evaluation of early graft remodeling by magnetic resonance imaging

Abstract

Objectives: To evaluate the graft remodeling phase following anterior cruciate ligament reconstruction augmentation with remnant preservation. Methods: Between March and December 2018 19 patients underwent anatomic single bundle anterior cruciate ligament reconstruction using hamstrings with preservation of the intact ligament fibres and the peri-ligamentous symovium when possible. All patients were subjected to magnetic resonance imaging at 2 and 4 months post-operatively. Patient demographics, percentage of intra-operative remnant preservation and graft magnetic signal intensity using the signal/noise quotient method were recorded. Results: 12 patients were male and 7 were female with a mean age of 26. 5 years. A low signal intensity in the mid portion of the graft was observed in those patients where a larger percentage of the ligament and synovium was preserved at 2 months post-operatively. The signal intensity was even lower at the 4 month scan. Conclusions: Remnant preserving anterior cruciate ligament reconstruction seems to lead to quicker graft remodeling as reflected in the post-operative magnetic resonance signal intensity. Graft revascularization and remodeling seem to correlate with the percentage of remnant preservation. These results support the use of fast-track rehabilitation protocols in this set of patients.