Anterior cruciate ligament reconstruction in partial tear: Selective anteromedial bundle reconstruction conserving the posterolateral remnant versus single-bundle anatomic ACL reconstruction: Preliminary 1-year results of a prospective randomized study

Pujol, Nicolas; Colombet, Philippe; Potel, J.-F.; Cucurulo, T.; Graveleau, Nicolas; Hulet, C.; Panisset, Jean-Claude; Servien, Elvire; Sonnery‐Cottet, Bertrand; Trojani, Christophe; Djian, P.

doi:10.1016/j.otsr.2012.09.007

Cited by 61 publications

(63 citation statements)

References 26 publications

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“…Moreover, to strengthen the utility of this procedure, Adachi et al [1], who compared 40 selective reconstructions with a control group of conventional total reconstructions, found that preserving the intact bundle reduces postoperative knee laxity but mostly adds joint stability and proprioception thanks to the preservation of a greater amount of mechanoreceptors. Even Pujol et al [28], in their case-control study, reported the same knee laxity results as above, but only for the first year after surgery, while the difference in laxity was not significant after 2 years. Focusing on postoperative knee laxity, only one recent study has compared results after selective reconstruction of ACL in patients with preoperative Kneelax arthrometer ≤ 5 mm and pivot shift test < II grade (group A) and in patients with Kneelax arthrometer ≥ 5 mm and/or pivot shift test ≥ II grade (group B) [23].…”

Section: Discussionmentioning

confidence: 52%

Partial rupture of anterior cruciate ligament: preliminary experience of selective reconstruction

et al. 2020

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Background: Partial lesions of the anterior cruciate ligament (ACL) are more common than is generally thought, accounting for about 10-12% of ACL injuries. Selective reconstruction may be considered as an option in isolated bundle rupture. The purpose of this study is to evaluate both subjective and objective clinical results, as well as functional recovery time, after selective arthroscopic single-bundle reconstruction in a consecutive series of patients affected by partial ACL rupture. Materials and methods:Thirty-six patients undergoing selective reconstruction of a single ACL bundle were retrospectively evaluated from a series of 354 ACL reconstructions performed over a 3-year period. Although the suspicion of partial lesions was present at clinical and magnetic resonance imaging (MRI) evaluation, final diagnosis was obtained during arthroscopy. All patients were operated using the same technique and type of fixation, and undergoing the same functional recovery protocol.Results: Mean follow-up was 64 months (48-84 months). All patients but one achieved good functional recovery and returned to their sports within a mean period of 6.1 months. A single patient complained of postoperative instability 1 year after the index operation and needed further surgery. No complications were recorded. Conclusions:Selective reconstruction of partial ACL injury is a method to bear in mind because it offers quick functional recovery. Specific technical and diagnostic steps should be performed and discussed with patients preoperatively. Level of evidence:Level 4, retrospective study.

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Section: Discussionmentioning

confidence: 52%

Partial rupture of anterior cruciate ligament: preliminary experience of selective reconstruction

et al. 2020

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“…After removing duplicate articles (19), 117 were identified by screening titles and abstracts. Finally, five RCTs [5,[10][11][12][13] and six observational studies [14][15][16][17][18][19] were included in this meta-analysis with subgroup analysis. A summary of the review process is presented in Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Specifically, two researchers extracted the following information from each study: first author, year of publication, country where the study was performed, study design (Tables 2 and 3). To obtain the omitted data, we e-mailed some authors [5,[10][11][12][13][14][15][16][17][18][19]. The meta-analysis was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines.…”

Section: Data Extractionmentioning

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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“…4 Standard single-bundle ACL reconstructions have been widely considered to provide improved clinical and functional outcomes. 5 However, performing an ACL augmentation procedure can be appropriate and advantageous when considering the roles of proprioception and biological healing.…”

mentioning

confidence: 99%

“…[4][5][6][7][8][9][10][11][12] Additionally, as the ACL-deficient knee has also been shown to exhibit less proprioceptive feedback contributing to instability, preservation of remnants may offer an inherent component of stability. 13 Previous literature suggests that ACL augmentation procedures have favorable outcomes: Nakamae et al found significantly better graft coverage and mean side-to-side laxity differences in patients with single-bundle ACL augmentations than in those with double-bundle and singlebundle ACL reconstructions.…”

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confidence: 99%

Single-Bundle Augmentation for a Partial Tear of the Anterior Cruciate Ligament

Rao

Cvetanovich

Zuke

et al. 2017

Arthroscopy Techniques

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Given the prevalence of anterior cruciate ligament (ACL) tears in young athletes, it is essential to elucidate and illustrate surgical interventions that return the most favorable outcomes. Although most ACL injuries are full-thickness tears, occasionally either the anteromedial (AM) or posterolateral (PL) bundle is torn in isolation, allowing consideration of an ACL reconstruction or augmentation. Because the ACL-deficient knee has been shown to exhibit less proprioceptive feedback, the preservation of the intact bundle may offer an inherent component of stability. After arthroscopy has confirmed a partial ACL tear, the decision to augment the intact bundle can be made. The technique is adapted from principles of the double-bundle reconstruction such that the graft follows the path of either the native AM bundle or the native PL bundle, depending on the location of the partial tear. We present our surgical technique for ACL AM bundle augmentation with PL bundle reconstruction using a semitendinosus tendon autograft.

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Anterior cruciate ligament reconstruction in partial tear: Selective anteromedial bundle reconstruction conserving the posterolateral remnant versus single-bundle anatomic ACL reconstruction: Preliminary 1-year results of a prospective randomized study

Cited by 61 publications

References 26 publications

Partial rupture of anterior cruciate ligament: preliminary experience of selective reconstruction

Partial rupture of anterior cruciate ligament: preliminary experience of selective reconstruction

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

Single-Bundle Augmentation for a Partial Tear of the Anterior Cruciate Ligament

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