Arthroscopic Anterior Cruciate Ligament Reconstruction With the Tibial-Remnant Preserving Technique Using a Hamstring Graft

Lee, Byung-Ill; Min, Kyung-Dae; Choi, Hwan Jun; Kim, Jun-Bum; Kim, Seong-Tae

doi:10.1016/j.arthro.2005.11.010

Cited by 82 publications

(55 citation statements)

References 22 publications

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“…Namely, in the previously reported techniques, the proximal attachment has been completely detached to visualize the femoral condyle. [12][13][14][15][16][17] In the present study, we performed this tissue-preserving surgery for the knees with a Type-I, II, or III ACL remnant tissue reported by Crain et al 6 Such knees existed in 55% of a total of 80 patients who underwent ACL reconstruction in our hospital in the same period. Crain et al reported that the knees with a Type-I, II, or III ACL remnant tissue existed in 58% of their 48 patients who underwent ACL reconstruction.…”

Section: Discussionmentioning

confidence: 77%

“…[11][12][13][14][15][16] On the other hand, only a clinical report 17 has introduced a remnant-preserving technique for double-bundle ACL reconstruction, in which 2 femoral tunnels and one tibial tunnel were made, although anatomic double bundle ACL reconstruction procedures have recently attracted notice because of biomechanical advantages in laboratory studies. [18][19][20][21][22][23][24][25][26][27][28] However, no previous studies have shown clinical evidence about utility of the ACL remnant tissue preservation in ACL reconstruction as of yet.…”

Section: Introductionmentioning

confidence: 99%

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A Pilot Study of Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction With Ligament Remnant Tissue Preservation

Yasuda

Kondo

Kitamura

et al. 2012

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Purpose: The purpose of this pilot study is to clarify the preliminary results of an anatomic double-bundle ACL reconstruction procedure with ligament remnant tissues. Methods:Using the trans-tibial technique, 2 doubled semitendinosus tendons were grafted into 4 tunnels created at the center of each bundle attachment, penetrating the ACL remnant tissue. Forty-four patients (27 men and 17 women) with an isolated ACL injury underwent ACL reconstruction using this procedure. The mean age of subjects was 29 years (range: 17-58). Postoperative clinical evaluations were performed at 16.6 months on average (range: 12 -23). Radiological evaluations were also performed to evaluate the tunnel location in the femur and the tibia. Results:The average operation time was 86 minutes (range: 72 -96) in the cases with ACL reconstruction only. Postoperatively, the mean anterior laxity was 0.7 mm. The postoperative pivot-shift test was negative in 81.8 % of the patients, while there were no patients evaluated as ++. No patients showed any extension or flexion deficit. There were no patients evaluated as "Nearly abnormal" or "Abnormal" under the IKDC evaluation. The tunnel angles of the 4 tunnels were identical to those reported in the previous study. Conclusions:The minimal 1-year clinical results of anatomic double-bundle ACL 3 reconstruction with ligament remnant tissue preservation were comparable to the previously reported results of the anatomic double-bundle reconstruction without remnant tissue preservation.

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Section: Discussionmentioning

confidence: 77%

Section: Introductionmentioning

confidence: 99%

A Pilot Study of Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction With Ligament Remnant Tissue Preservation

Yasuda

Kondo

Kitamura

et al. 2012

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…1 However, the ACL remnant is usually debrided to create the correct femoral and tibial tunnels and to decrease the risk of impingement and cyclops lesions in traditional ACL reconstruction. [1][2][3] Good results have been reported after remnantpreserving ACL reconstruction using a transtibial technique. 4,5 However, another important point to consider is an anatomic reconstruction at the footprint of the native ACL.…”

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confidence: 89%

Creation of an Anatomic Femoral Tunnel With Minimal Damage to the Remnant Bundle in Remnant-Preserving Anterior Cruciate Ligament Reconstruction Using an Outside-In Technique

Ahn

Lee

2014

Arthroscopy Techniques

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We established a method for creation of an anatomic femoral tunnel with minimal damage to the remnant bundle in remnant-preserving anterior cruciate ligament (ACL) reconstruction. The goals of this surgical technique were to preserve the remnant bundle as much as possible, especially at the femoral insertion, and to make the tunnel at the anatomic position. The critical points are that the posterior side of the femoral footprint of the ACL is observed through the posterolateral portal using a 70 arthroscope and a femoral tunnel is made by use of an outside-in technique with remnant preservation. This technique allows for easy viewing of the posterior side of the ACL and enables performance of an anatomic ACL reconstruction.

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“…The term "ACL remnant" has been used to signify both a continuous strand of tissue between the tibia and the notch (or the PCL) even with a complete ACL deficiency, 1,11 as well as the stump of the ACL tissue left at the tibial (or femoral) attachment site. 2,7,8,12 These 2 concepts need to be clearly differentiated in the literature to aid in summarizing the results of different studies. We suggest that the term "remnant" may be used for the former (a continuous strand) and the term "stump" may be used for the latter to avoid confusion.…”

Section: Discussionmentioning

confidence: 99%

Anterior Cruciate Ligament Reconstruction With Preservation of Femoral Anterior Cruciate Ligament Stump

Nag

Gupta

2014

Arthroscopy Techniques

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Anterior cruciate ligament (ACL) reconstruction with preservation of either the remnant or the tibial stump is performed with the hope of improving the vascularization and proprioceptive function of the graft. Remnant preservation is technically difficult because it hinders the visualization of the intra-articular tunnel site. Taking a cue from the concept of tibial stump preservation, we have modified our ACL reconstruction technique to preserve a sleeve of the soft tissue and ACL stump attached to the femoral condyle, in addition to tibial stump preservation, while still allowing adequate visualization of the femoral ACL insertion site. We describe our modification in this article and hypothesize that this should further improve graft vascularization and ligamentization.

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Arthroscopic Anterior Cruciate Ligament Reconstruction With the Tibial-Remnant Preserving Technique Using a Hamstring Graft

Cited by 82 publications

References 22 publications

A Pilot Study of Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction With Ligament Remnant Tissue Preservation

A Pilot Study of Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction With Ligament Remnant Tissue Preservation

Creation of an Anatomic Femoral Tunnel With Minimal Damage to the Remnant Bundle in Remnant-Preserving Anterior Cruciate Ligament Reconstruction Using an Outside-In Technique

Anterior Cruciate Ligament Reconstruction With Preservation of Femoral Anterior Cruciate Ligament Stump

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