Department of orthopedics, General Hospital of Northern Theater Command, Shenyang, 110016, China.
BMC Musculoskelet Disord. 2022 Dec 5;23(1):1066. doi: 10.1186/s12891-022-05912-7.
To investigate the clinical application of modified Crain classification in anterior cruciate ligament (ACL) reconstruction (ACLR) with remnant preservation.
The subjects were 70 patients with ACL injury who underwent ACLR from May 2016 to June 2018, and their general data were recorded. They were randomly divided into modified remnant-preserved ACLR group (group M, n = 35) and non remnant-preserved ACLR group (group N, n = 35). ACLR program with remnant preservation was designed based on modified Crain classification in group M, while ACL remnants were completely cleaned during ACLR in group N. Subsequently, the two groups were compared in terms of operation time, complications, as well as Lysholm score, international knee documentation committee (IKDC) score and positive rate of Lachman test of knee joint before operation and at 3, 6 and 12 months after operation.
Both the groups showed good postoperative efficacy, and none had complications like limited knee extension or cyclops lesion. The comparison results found that group M (72.49 ± 7.64 min) required longer operation time than group N (66.06 ± 6.37 min) (P < 0.05). Lysholm score and IKDC score at 3, 6 and 12 months after operation in the two groups were significantly higher than those before operation (P < 0.05); group M had higher Lysholm score and IKDC score at 3 months and 6 months after operation compared with group N (P < 0.05). Additionally, the positive rate of Lachman test at 3, 6 and 12 months after operation in both groups was significantly lower than that before operation (P < 0.05), but there was no significant difference between group M and group N.
With the modified Crain classification, many remnant-preserved reconstruction techniques can be rationally used to completely preserve the remnant ligament tissue during operation and improve knee joint function and joint stability with few complications.
探讨改良 Crain 分类在前交叉韧带（ACL）重建（ACLR）中保留残端的临床应用。
选取 2016 年 5 月至 2018 年 6 月收治的 70 例 ACL 损伤患者，记录其一般资料。将其随机分为改良保留残端 ACLR 组（M 组，n=35）和非保留残端 ACLR 组（N 组，n=35）。M 组基于改良 Crain 分类设计保留残端 ACLR 方案，N 组在 ACLR 时完全清除 ACL 残端。比较两组手术时间、并发症及术前、术后 3、6、12 个月膝关节 Lysholm 评分、国际膝关节文献委员会（IKDC）评分和 Lachman 试验阳性率。
两组术后疗效均良好，无膝关节伸直受限或“独眼畸形”等并发症。M 组（72.49±7.64）min 的手术时间长于 N 组（66.06±6.37）min（P<0.05）。两组术后 3、6、12 个月的 Lysholm 评分和 IKDC 评分均高于术前（P<0.05），M 组术后 3、6 个月的 Lysholm 评分和 IKDC 评分高于 N 组（P<0.05）。两组术后 3、6、12 个月的 Lachman 试验阳性率均低于术前（P<0.05），但 M 组与 N 组间比较差异无统计学意义。
采用改良 Crain 分类，可合理应用多种保留残端重建技术，术中完全保留残端韧带组织，并发症少，可改善膝关节功能和关节稳定性。
