Arthroscopic Anatomic Reconstruction Of Anterior Cruciate Ligament With Preservation Tibial Remnant Using Hamstring Autograft

Objectives To compare the outcome of anterior cruciate ligament （ACL）reconstruction with preserving versus removing the remnant of native ACL usinghamstring autograft．Methods From June2010to September2012, The Second Hospital Of Tang Shan injoint branch70patients with ACL tear were treated with hamstring autograft. On the basisof the ACL’s condition，patients were divided into2groups: the tibial remnant preservinggroup（n﹦37）and the control group（removing remnant，n﹦33）The tibial remnantpreserving group contain37patients27males and10females,aged18～53years (averagesage32.5years)21patients had injuries in the left knees,and16patients had injuries in theright knees. The control group contain33patients17males and16females,aged18～55years (averages age35.3years).15patients had injuries in the left knees,and18patientshad injuries in the right knees.15patients had injuries caused by daily sprain,23patientshad injuries caused by sports,32patients had injuries by traffic accident. The durationfrom injury to surgery was one week to eighteen months,with an average of4.2months.The anterior drawer test showed positive results in54patients, Lachman test showedpositive results in63patients,Both anterior drawer test and Lachman test showed positiveresults in42patients. Endobutton was used to fix the graft at the femoral,the tibial fixedby absorbable interference screw Before operation and at3,6,9,12months after operationand at last follow-up,the improvement of function of the knee joint was evaluated byLysholm score,the International Knee Documentation Committee (IKDC) scale andMarshall score.KT-2000arthrometer wasused to evaluate knee laxity. All of the patientshad undergone the surgeryby the same doctor,and basic same preoperative preparation andpostoperative rehabilitation plan.Results Seventy patients were followed up,and the mean follow-up time was24.5months (ranged15to25months), By the evaluation of KT-2000the both sides arthrometerside-to-side difference was smaller than3mm．The comparative differences of the twogroups at each time had no statiatic significance (P＞0.05). However，differences of theLysholm score and IKDC scale between preoperation and postoperation of both patientsgroups had statiatic significance (P＜0.05). Differences of the Lysholm score and IKDCscale at postoperative each time in both groups had statiatic significance(P＜0.05).At lastfollow-up，the Marshall score in tibial-remnant preserving group was lager than in thecontrol group，the differences were significant(P＜0.05).Conclusions arthroscopic anatomic reconstruction of anterior cruciate ligament withpreservation tibial remnant using hamstring autograft.which could increase theangiogenesis and enhance the tendon-bone healing of the ACL and improve theproprioception and increase stability of the knee.