Arthroscopic reconstruction of anterior cruciate ligament with and without remnant preservation: a Meta-analysis of prospective, randomized, and controlled studies

doi:10.12307/2021.229

Abstract

Abstract: OBJECTIVE: Arthroscopic reconstruction of the anterior cruciate ligament has become the preferred choice for anterior cruciate ligament injuries, but there is still a big controversy about whether to preserve the tibial remnant of the anterior cruciate ligament. Here, we attempt to systematically evaluate the clinical effect of anterior cruciate ligament reconstruction with and without remnant preservation under arthroscopy.
METHODS: PubMed, EMbase, the Cochrane Library, CBM, WanFang Data, CNKI and VIP databases were searched for clinical controlled studies regarding arthroscopic anterior cruciate ligament reconstruction with or without remnant preservation. The retrieval time was from inception of the databases to September 2019. Two researchers independently screened the literature, extracted data and evaluated the risk of bias in the included studies. Revman 5.3 software was then used for Meta-analysis.
RESULTS: Compared with the reconstruction without remnant preservation, there was higher Lysholm score [mean difference (MD)=2.20, 95% confidence interval (CI) (0.82, 3.58), P=0.001], higher International Knee Documentation Committee score (MD=2.28, 95% CI (1.20, 3.37), P < 0.001), lower KT1000/KT2000 score [MD =-0.29, 95% CI (-0.52, -0.06), P=0.01] after remnant-preserved reconstruction. There were no significant differences in the axial displacement test, Lachman test and the diameter of the tibial tunnel between the reconstruction with or without remnant preservation. Compared with the reconstruction without remnant preservation, the reconstruction with remnant preservation led to a better proprioception [MD=0.41, 95%CI (0.13, 0.69), P=0.004].
CONCLUSION: Existing evidence has shown that remnant-preserved reconstruction of the anterior cruciate ligament can improve the functional score, proprioception and objective stability of the knee joint after surgery, but there is no evidence that it is beneficial to subjective stability and to protecting the tibial tunnel.

Key words: remnant preservation, no remnant preservation, anterior cruciate ligament, systematic review, clinical efficacy

CLC Number:

Huang Honghui, Pan Huashan, Lai Chunbai. Arthroscopic reconstruction of anterior cruciate ligament with and without remnant preservation: a Meta-analysis of prospective, randomized, and controlled studies[J]. Chinese Journal of Tissue Engineering Research, 2021, 25(32): 5227-5231.

Figures/Tables 11

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