Rehab Plus Sports Therapy, Scottsdale, Arizona; and.
Emoto Knee and Sport Clinic, Fukuoka, Japan.
Clin J Sport Med. 2021 Jul 1;31(4):379-382. doi: 10.1097/JSM.0000000000000759.
Remnant-preserving anterior cruciate ligament reconstruction (ACLR) is sought to enhance vascularization and maturation of a graft and to produce positive clinical outcomes after reconstruction.
The purpose of this study was to investigate an effect of remnant anterior cruciate ligament (ACL) tissues on outcomes of ACLR 1 year after reconstruction in younger populations.
Retrospective chart review.
Inpatient orthopedic surgical and rehabilitation clinic.
The subjects were 644 patients who underwent primary ACLR.
The independent variables were age, height, and body weight of the subjects, and the presence of remnant tissue.
The outcome measure was the number of subjects with secondary infra-articular injuries at a follow-up arthroscopy after ACLR. The odds ratio was calculated and compared between the remnant-preserving ACLR (ACLR-P) and remnant-resecting (ACLR-R) groups to investigate the effect of remnant tissues on postoperative outcomes.
A total of 416 cases met our inclusion criteria and were included in this study. There were 136 cases (49 males and 87 females) in the ACLR-P group with the mean age (±SD) of 17.86 ± 2.85 years. There were 280 cases (106 males and 174 females) in the ACLR-R group, and the mean age (±SD) was 18.13 ± 2.73 years. Of 136 cases in the ALCR-P group, 54 (39.7%) had abnormal arthroscopic findings that lead to a surgical intervention. Of 280 patients in the ACLR-R group, 128 (45.7%) had abnormal findings. Odds ratio was 0.78 [95% confidence interval (CI), 0.51-1.18; P = 0.24]. Four cases in the ACLR-P group and 8 in the ACLR-R group were diagnosed with ACL retear during follow-up arthroscopy. Odds ratio was 1.03 (95% CI, 0.30-3.48; P = 0.96).
The presence of ACL remnant tissues did not have a significant effect on outcomes 1 year after reconstruction. However, there was a trend that lower percentage of patients with remnant-preserving ALCR had abnormal arthroscopic findings that lead to a surgical treatment at follow-up arthroscopy 1 year after initial reconstruction. The presence of remnant tissues did not have a significant effect on retear rate.
保留残端的前交叉韧带重建（ACLR）旨在增强移植物的血管化和成熟度，并在重建后产生积极的临床结果。
本研究旨在探讨年轻患者中残留前交叉韧带（ACL）组织对 ACLR 后 1 年重建结果的影响。
回顾性图表审查。
住院骨科手术和康复诊所。
644 名接受初次 ACLR 的患者。
受试者的年龄、身高和体重以及是否存在残端组织。
主要观察指标是在 ACLR 后随访关节镜检查中出现继发性关节下损伤的受试者数量。计算并比较保留残端 ACLR（ACLR-P）和切除残端（ACLR-R）组之间的优势比，以探讨残端组织对术后结果的影响。
共有 416 例符合纳入标准，并纳入本研究。ACLR-P 组有 136 例（49 名男性和 87 名女性），平均年龄（±SD）为 17.86 ± 2.85 岁。ACLR-R 组有 280 例（106 名男性和 174 名女性），平均年龄（±SD）为 18.13 ± 2.73 岁。在 ACLR-P 组的 136 例中，54 例（39.7%）有导致手术干预的异常关节镜发现。在 ACLR-R 组的 280 例患者中，有 128 例（45.7%）有异常发现。优势比为 0.78 [95%置信区间（CI），0.51-1.18；P = 0.24]。ACLR-P 组中有 4 例和 ACLR-R 组中有 8 例在随访关节镜检查中被诊断为 ACL 再撕裂。优势比为 1.03（95%CI，0.30-3.48；P = 0.96）。
ACL 残端组织的存在对重建后 1 年的结果没有显著影响。然而，有一个趋势表明，保留残端的 ACLR 患者中，有较低比例的患者在初次重建后 1 年的随访关节镜检查中出现异常关节镜发现，需要手术治疗。残端组织的存在对再撕裂率没有显著影响。
