Effects of Remnant Tissue Preservation on Clinical and Arthroscopic Results After Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction

Kondo, Eiji; Yasuda, Kazunori; Onodera, Jun; Kawaguchi, Yasuyuki; Kitamura, Nobuto

doi:10.1177/0363546515587713

Cited by 71 publications

(137 citation statements)

References 48 publications

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“…Through our literature search, 552 potentially relevant studies were identified. 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.…”

Section: Resultsmentioning

confidence: 99%

“…Five RCTs [5,[10][11][12][13] and five observational studies [15][16][17][18][19] reported arthrometric evaluation (KT-1000, KT-2000, Rolimeter, magnitude of side-to-side difference). A total of 472 patients in remnant-preserving groups and 485 patients in non-preserving groups were analyzed.…”

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%

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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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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Data Extractionmentioning

confidence: 99%

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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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“…These findings can be applied to recently described remnant preservation ACL reconstruction techniques. 8,16,19 …”

Section: Discussionmentioning

confidence: 99%

Synovial C-Shaped Tibial Footprint of the Anterior Cruciate Ligament

Janovsky

Kaleka

Alves

et al. 2016

Orthopaedic Journal of Sports Medicine

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Background:Although numerous anatomic studies about the anterior cruciate ligament (ACL) structure and attachments have been performed, these studies have not reached consensus on the ACL footprint.Purpose:To investigate the existing controversy regarding the morphology of the tibial ACL insertion (footprint) and confirm histologically that the tibial ACL footprint is not completely filled with ligament tissue.Study Design:Descriptive laboratory study.Methods:The tibial ACL footprint was dissected from 20 different fresh-frozen cadaveric knees (all males; mean age, 68.8 ± 5.4 years [range, 55-80 years]; mean weight, 78 ± 6.6 kg [range, 45-93 kg]). Two knees, 1 with severe osteoarthritis and 1 with previous knee surgery, were excluded. The tibial ACL insertion was observed, and this area was longitudinally divided into 4 parallel slices (0%-25%, 25-50%, 50%-75%, and 75%-100%), embedded in paraffin wax, and stained with hematoxylin-eosin, alcian blue, and picrosirius-polarization. The specimens were measured using a microscope to determine the distances from the anterior to the posterior border of the ACL ligament tibial insertion and the distance from the posterior border to the end of the ligament fibers of the ACL ligament tibial insertions.Results:The 18 evaluated knee specimens confirmed the finding of a C-shaped tibial insertion of the ACL. The measurements showed that the ligament (vertical parallel collagen fibers) occupied only 30.8% of the complete insertion. The remaining area was filled with synovial tissue, demonstrating histologically the “C” shape.Conclusion:This study confirms macroscopically the C-shaped tibial insertion of the ACL and shows histologically that synovial tissue is an indirect insertion filling the major part of the footprint.Clinical Relevance:This anatomic study suggests a different shape of the ACL tibial footprint, which may be useful for new perspectives regarding ACL reconstruction surgery research.

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“…эспериментальные исследования, проведен-ные e. Kondo с соавторами, показали, что такие остатки культи пкс, циркулярно прилегая к по-верхности дистальной части трансплантата, обе-спечивают клеточную пролиферацию, регене-рацию проприоцептивных элементов и в итоге уменьшают остаточную нестабильность сустава [14]. но репаративный потенциал пкс после ее разрыва невысок.…”

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Modern Trends in Surgical Treatment of Patients With Acl Ruptures (Literature Review)

Rikun

Хоминец

Федотов

2017

Traumatology and Orthopedics of Russia

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The authors conducted an analysis of national and foreign scientific publications dedicated to the problems in treatment of patients with ruptures of the anterior cruciate ligament of the knee joint. The results of the analysis demonstrated that such lesions still remain the key knee pathology resulting from sports injuries that significantly affect knee function and require timely reconstructive surgical correction. Based on the study the key areas of improvement in treatment for mentioned category of patients have been identified. This is the biomechanically justified single bundle anatomical ACL reconstruction which is currently widely applied in the clinical practice by using of an isometrically located autograft. Such technique represents a radically new stage in the development of treatment methods for young and middle-aged patients with high functional demands.

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Effects of Remnant Tissue Preservation on Clinical and Arthroscopic Results After Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction

Cited by 71 publications

References 48 publications

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

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

Synovial C-Shaped Tibial Footprint of the Anterior Cruciate Ligament

Modern Trends in Surgical Treatment of Patients With Acl Ruptures (Literature Review)

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