Department of Trauma and Orthopedics, Faculty of Medicine (Kasr Alainy), Cairo University, Cairo, Egypt.
BMC Musculoskelet Disord. 2022 Jul 23;23(1):703. doi: 10.1186/s12891-022-05665-3.
Anterior Cruciate ligament (ACL) reconstruction (ACLR) aims to restore the anatomy and function of the knee. Although stump preservation during ACLR could be technically challenging, it may improve the revascularization and proprioceptive function of the graft. In this study, we aimed to compare the functional outcome after ACLR with and without stump preservation.
One hundred and twenty patients with acutely torn ACL and with intact tibial stump were included in this study. Half of them (60 cases) underwent ACLR with stump preservation. The other half (60 cases) had ACLR after total resection of the tibial stump. One hundred and nine out of 120 cases completed their 2 year-follow-up period. All patients were assessed by Tegner activity, Lysholm, and objective International Knee Documentation Committee (IKDC) scores. The side-to-side difference regarding stability was assessed by KT-1000 instrumented Lachman and proprioceptive function was measured by Passive angle reproduction test.
There was no statistically significant difference between both groups regarding Tegner activity, Lysholm, and IKDC scores. Knee stability measured by KT-1000 and complication rate also showed no significant difference. But there was a significant difference in proprioception favoring stump preservation. On the other hand, the operative time was significantly shorter with stump resection. There was no significant difference in the complications rate between both groups and there were no cases with stiffness in either group.
Stump preservation ACLR is a safe technique that yields equivalent functional outcomes to standard ACLR. However; it provides better proprioception. It is more technically challenging, but in experienced hands; it is easily reproducible.
Registration number: NCT05364398 . 06/05/2022.
前交叉韧带（ACL）重建（ACLR）旨在恢复膝关节的解剖结构和功能。虽然 ACLR 过程中保留残端在技术上具有挑战性，但它可能会改善移植物的再血管化和本体感觉功能。在这项研究中，我们旨在比较 ACLR 时保留残端和不保留残端的功能结果。
本研究纳入了 120 例急性 ACL 撕裂且胫骨残端完整的患者。其中一半（60 例）接受了保留残端的 ACLR，另一半（60 例）则在胫骨残端完全切除后进行了 ACLR。120 例中有 109 例完成了 2 年随访。所有患者均通过 Tegner 活动度、Lysholm 评分和客观国际膝关节文献委员会（IKDC）评分进行评估。通过 KT-1000 仪器化的 Lachman 测试评估稳定性的侧间差异，通过被动角度重现测试测量本体感觉功能。
两组患者在 Tegner 活动度、Lysholm 评分和 IKDC 评分方面无统计学差异。KT-1000 测量的膝关节稳定性和并发症发生率也无显著差异。但在保留残端方面，本体感觉存在显著差异。另一方面，残端切除的手术时间明显更短。两组的并发症发生率无显著差异，且两组均无僵硬病例。
保留残端的 ACLR 是一种安全的技术，其功能结果与标准 ACLR 相当。然而，它提供了更好的本体感觉。虽然技术上更具挑战性，但在经验丰富的手中，它很容易重现。
注册号：NCT05364398. 06/05/2022。
