MedPath

Comparison of Remnant Preserving Versus Remnant Resecting Anterior Cruciate Ligament Reconstruction

Not Applicable
Conditions
Anterior Cruciate Ligament Rupture
Interventions
Procedure: anterior cruciate ligament reconstruction
Registration Number
NCT02555917
Lead Sponsor
The Catholic University of Korea
Brief Summary

Anterior cruciate ligament injury is very common knee injury. Especially Anterior cruciate ligament complete rupture leads to knee joint instability and degenerative change of the knee. Anterior cruciate ligament reconstruction is performed for resolving these problems and it gives excellent results. For leading to successful result of anterior cruciate ligament reconstruction, selecting of appropriate femoral tunnel and tibial tunnel is necessary. If selecting inappropriate tibial tunnel location makes pain, synovitis, impingement of transplanted tendon, loss of range of motion, instability, failure of transplantation and risk of arthritis. It is known that selection of inappropriate tibial tunnel location is the most common cause of anterior cruciate ligament reconstruction failure.

Recently many studies reconstructed at anatomical lesion instead of isometric point. And some cadaver studies reported that tibial insertion of anterior cruciate ligament has "C" shape. There are two methods for anterior cruciate ligament reconstruction. One is preserving remnant and the other is removing remnant.

This study aims to compare the tibia and femoral tunnel location of remnant preserving and remnant resecting anterior cruciate ligament reconstruction.

Detailed Description

The study design is a double-blind randomized controlled trial. Randomly, twenty patients planed to undergo anterior cruciate ligament reconstruction using autograft by remnant preserving and other twenty patients undergo anterior cruciate ligament reconstruction using autograft by resecting anterior cruciate ligament. The clinical outcome is comparative preoperative, postoperative 6weeks, 3months, 6months and 1years. And clinical score consists of Visual Analog Score, lachman test, anterior laxity, Lysholm knee score, international knee documentation committee score. Femoral and tibial tunnel location will be analyzed by three-dimensional computed tomography using Bernard quadrant method after surgery.

The present study aimed to determine and compare (1) the accuracy of tibia and femoral tunnel location and (2) postoperative functional outcome after anterior cruciate ligament reconstruction between remnant preserving group versus remnant resecting group.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
40
Inclusion Criteria
  • over 19 years old
  • patients for ACL reconstruction having medicare insurance
Exclusion Criteria
  • infection
  • previous surgery experience
  • progressive osteoarthritis

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Remnant resectinganterior cruciate ligament reconstructionAnterior cruciate ligament reconstruction: anterior cruciate ligament remnant will be removed in the operation
Remnant preservinganterior cruciate ligament reconstructionAnterior cruciate ligament reconstruction: anterior cruciate ligament remnant will be preserved in the operation
Primary Outcome Measures
NameTimeMethod
Bernard quadrant method using 3-dimensional computed tomography for the femoral and tibial tunnel location1 week after surgery

The locations of the tunnels will be quantified and presented as the percentage distance from the deepest subchondral contour and the intercondylar notch roof to the center of the tunnel by use of the Bernard quadrant method.

Secondary Outcome Measures
NameTimeMethod
Visual Analog Score for pain6weeks, 3months, 6months and 1years after surgery

Scores range from 0 \[no pain\] to 10 \[worst possible pain\].

Knee Laxity Testing Device(KT1000) for amount of increased anterior knee translation6weeks, 3months, 6months and 1years after surgery

If increased translation, 3 mm or more will be checked compared to the normal contralateral knee.

Lysholm knee score for functional outcome6weeks, 3months, 6months and 1years after surgery

Scores range from 0 \[worst possible function\] to 100 \[normal function\].

International Knee Documentation Committee Score for functional outcome6weeks, 3months, 6months and 1years after surgery

Scores range from 0 \[worst possible function\] to 100 \[normal function\].

© Copyright 2025. All Rights Reserved by MedPath