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Clinical outcomes of remnant preserving augmentation in anterior cruciate ligament reconstruction: a systematic review

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The objective of this study was to systematically review the current evidence to see whether the remnant preservation techniques could obtain better clinical outcomes than the standard anterior cruciate ligament reconstruction procedure.

Methods

The authors systematically searched online databases to identify the studies which compared the remnant preservation techniques with the standard techniques. Two reviewers independently extracted data and evaluated the methodological quality of each study. Clinical outcomes in terms of knee stability, clinical scores, vascularization, proprioception, tibial tunnel enlargement and complications were qualitatively compared.

Results

Thirteen studies met the inclusion criteria for review. Compared with the standard procedure, significantly better results regarding knee stability in the remnant preserving group were reported in two of nine studies in the instrumented knee laxity, one of eight studies in the Lachman test and none of eight studies regarding the pivot shift test. Five studies assessed International Knee Documentation Committee scores but found no differences. One of two studies indicated significantly earlier revascularization according to the signal/noise quotient value of the graft on magnetic resonance imaging. One of two studies indicated significantly better proprioceptive function in terms of joint position sense using the reproduction of passive positioning test. Two of two studies showed significantly less tibial tunnel enlargement in the remnant preserving group. None of the studies showed significant increase in the risk of cyclops lesion formation and the loss of knee range of motion in the remnant augmentation group.

Conclusions

The current evidence suggests that the short-term clinical outcomes of patients with the remnant augmentation technique are comparable, if not superior, with that of patients undergoing the standard technique, although it is insufficient to justify the remnant preserving augmentation as a routine treatment for anterior cruciate ligament ruptures.

Level of evidence

Systematic review, Level IV.

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Acknowledgments

This work was supported by The National Natural Science Foundation of China (No. 81171699). The authors thank Ramona L. Kirk and Hugo Giambini (Mayo Clinic) for English editing.

Conflict of interest

The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Department of Sports Medicine and Research Center of Sports Medicine, Xiangya Hospital, Central South University, Changsha, 410008, People’s Republic of China

    Jianzhong Hu, Jin Qu, Daqi Xu, Tao Zhang, Jingyong Zhou & Hongbin Lu

  2. Department of Spine Surgery, Xiangya Hospital, Central South University, Changsha, 410008, People’s Republic of China

    Jianzhong Hu, Jin Qu & Tao Zhang

Authors
  1. Jianzhong Hu
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  2. Jin Qu
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  3. Daqi Xu
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Correspondence to Hongbin Lu.

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Hu, J., Qu, J., Xu, D. et al. Clinical outcomes of remnant preserving augmentation in anterior cruciate ligament reconstruction: a systematic review. Knee Surg Sports Traumatol Arthrosc 22, 1976–1985 (2014). https://doi.org/10.1007/s00167-013-2749-8

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  • DOI: https://doi.org/10.1007/s00167-013-2749-8

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