Comparison of retaining ligament stump and non-reserving stump on anterior cruciate ligament reconstruction by arthroscopy
HUANG Yuan-xia, XU Hai-bin，TAO Jin-gang， MING Hai-wu
Chinese Journal of Clinical Anatomy ›› 2017, Vol. 35 ›› Issue (5) : 564-566.
Comparison of retaining ligament stump and non-reserving stump on anterior cruciate ligament reconstruction by arthroscopy
Objective To compare the outcome of anterior cruciate ligament ( ACL) reconstruction under Arthroscopy with preserving versus removing the remnant of native ACL using hamstring autograft．Methods From March 2014 to May 2015, 64 patients underwent ACL reconstruction using hamstring autograft. They were randomly divided into two groups, with 32cases in each group. The control group removed residual ligament and the experimental group retained ligament stump Preoperative, postoperative joint stability, and functional scores were recorded and compared in the two groups. 1 year after the operation the proprioception was tested in all patients, and some patients underwent a second surgery to explore the reconstruction of the ligament. Result 64 cases were followed up with a length of 12~27 months. One year after the operation results were compared. The Lysholm score of the control group was 91.9 points, and that of experimental group was 93.2 points; IKDC score of the control group in grade A and B was 29 cases, and that of the experimental group was 30 cases; the drawer test negative in control group was 29 cases and in experimental group was 31 cases. Lachman test in the two group was both 30 cases, and there was no statistically significant difference (P>0.05).The proprioception repeated test of two group had no significant difference. The self-reported joint stability and position sense in the experimental group was better than that of the control group after operation. There were 9 patients underwent a second arthroscopic surgery, with 4 cases in the control group and 5 cases in the experimental group. Microscopically, synovial coverage and ligament surface smoothness of the observation group were better than in the control group. Because the number of cases is too small, no statistical analysis was performed. Conclusions Anterior cruciate ligament (ACL) reconstruction under Arthroscopy with preserving versus removing the remnant of native ACL could both result in satisfactory clinical outcomes. However，the proprioception of patients in the stump-preserving group was better than that in the non-preserving group possibly due to the revascularization and re-establishment of the proprioception facilitated by the stump preservation, which requires confirmation with more data.
Anterior cruciate ligament injury / anterior cruciate ligament reconstruction / retained stump / arthroscopy
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