Preservation of remnant with poor synovial coverage has no beneficial effect over remnant sacrifice in anterior cruciate ligament reconstruction View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2017-08-19

AUTHORS

Bo Hyun Kim, Joong Il Kim, Osung Lee, Ki Woung Lee, Myung Chul Lee, Hyuk Soo Han

ABSTRACT

PurposeThe purpose of the study was to evaluate the influence of synovial coverage of the remnant on clinical outcomes and graft healing in anterior cruciate ligament (ACL) reconstruction.MethodsSeventy-five patients who underwent second-look arthroscopy after a single-bundle ACL reconstruction using autologous quadriceps tendon graft were included. The patients were divided into two groups according to whether the remnant was preserved (group P, n = 42) or sacrificed (group S, n = 33). Group P was further classified according to the degree of synovial coverage of the remnant on initial arthroscopic findings: group A (remnant fully covered with synovium, n = 15), group B (synovial coverage >50%, n = 15), and group C (coverage <50%, n = 12). Clinical outcomes including manual laxity tests, KT-2000 side-to-side difference, modified Lysholm score, Tegner activity score, and International Knee Documentation Committee score were evaluated pre-operatively and prior to the second-look arthroscopy. Graft tension, degrees of synovialization, and gross integrity were evaluated on second-look arthroscopic examination.ResultsThere were no statistical differences in manual laxity tests, KT-2000 side-to-side difference, and clinical scores between groups P and S. In second-look arthroscopic examination, graft tension showed no difference between the two groups, but gross integrity and synovialization were significantly higher in group P (P = 0.032 and P = 0.008, respectively). In subgroup analysis, only group A showed higher grade regarding gross integrity and synovialization in comparison with group S (P = 0.007 and P < 0.001, respectively).ConclusionsPreservation of remnant in ACL reconstruction showed no superiority concerning knee stability and clinical outcomes over remnant sacrificing at post-operative 1-year second-look arthroscopy. Preservation of remnant with good synovial coverage had a positive effect on graft synovialization and maintenance of graft integrity, but this effect was not observed in cases of a remnant with poor synovial coverage. When deciding whether to preserve the remnant or not, the degree of synovial coverage should be considered.Level of evidenceIII. More... »

PAGES

2345-2352

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00167-017-4683-7

DOI

http://dx.doi.org/10.1007/s00167-017-4683-7

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1091244767

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/28822999


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