Research Article

Is Remnant Preserving Single Bundle Reconstruction Surgery an Effective Method in Partial Anterior Cruciate Ligament Rupture?

10.4274/atfm.galenos.2021.52714

  • Emre Anıl Özbek
  • Mustafa Onur Karaca
  • Furkan Yılmaz
  • Mustafa Mert Terzi
  • Merve Dursun
  • Ramazan Akmeşe

Received Date: 03.06.2021 Accepted Date: 07.06.2021 J Ankara Univ Fac Med 2021;74(3):304-309

Objectives:

10%-27% of anterior cruciate ligament (ACL) injuries are partial ruptures. There is no consensus yet on the gold standard surgical treatment for the partial ACL ruptures. Single-bundle ACL primary repair, single-bundle ACL reconstruction, and total ACL reconstruction methods are described. The aim of our study is the evaluation of the clinical results, and the ligamentization of the graft in magnetic resonance (MR) imaging of patients who underwent single-bundle ACL reconstruction with the remnant-sparing method.

Materials and Methods:

Of the 257 patients who underwent ACL reconstruction at our clinic, 15 [posterolateral bundle (n=5), anteromedial bundle (n=10)] patients who underwent single-bundle ACL reconstruction were included. Inclusion criteria for the retrospective study were the presence of knee sprain history, positive Lachman test, negative or 1+ pivot shift test, suspected partial ACL rupture on MR imaging, and partial ACL rupture at intraoperative arthroscopic imaging as definitive diagnosis. The exclusion criteria included the history of previous knee surgery, multiple ligament injury, and total ACL reconstruction. Anterior drawer, Lachman and pivot shift results, International Knee Documentation Commitee (IKDC) and Lysholm scores of all patients at preoperative period, postoperative 3rd, 6th, 12th and 24th months were compared.

Results:

For Lachman and pivot shift, preoperative results were significantly higher (p=0.0149, p=0.005). There was a significant difference between the Lysholm and IKDC scores of the patients at preoperative period, postoperative 3rd, 6th, 12th and 24th months (p<0.001). In the post-hoc analysis, it was seen that there was a significant difference for each period. There was no patient without ligamentization in the MR imaging at 6 months postoperatively.

Conclusion:

Although it has technical difficulties for the surgeon, selective single-bundle ACL reconstruction is a surgical method with good clinical results. Due to rapid postoperative vascularization, better proprioceptive senses and stable knee examinations, selective ACL reconstruction surgery should be preferred by orthopedic surgeons for partial ACL ruptures at first place.

Keywords: Anterior Cruciate Ligament, Partial Rupture, Single Bundle Reconstruction, Arthroscopy

Full Text (Turkish)