Remnant Preservation in Anterior Cruciate Ligament Reconstruction: Does Stump Suturing Reduce the Risk of Tibial Tunnel Widening? A CT-Based Study
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Cairo University
- Enrollment
- 190
- Locations
- 1
- Primary Endpoint
- Rate of Tibial Tunnel Enlargement
Study Overview
Brief Summary
Anterior Cruciate Ligament (ACL) reconstruction is one of the most commonly performed orthopedic procedures. Tibial tunnel widening is a recognized postoperative complication that may affect graft stability and long-term outcomes. Recent studies have suggested that preserving the ACL remnant may improve biological healing and reduce tunnel widening, but the evidence remains inconclusive.
This prospective randomized study aims to evaluate whether remnant (stump) preservation and suturing during ACL reconstruction can reduce the risk of tibial tunnel widening compared with the conventional stump-resection technique.
A total of 190 patients with recent ACL tears (<6 months) were randomly assigned into two equal groups: Group A underwent arthroscopic ACL reconstruction with remnant suturing, while Group B underwent standard reconstruction with stump resection. All patients were followed for 12 months postoperatively with serial CT evaluations to assess tunnel diameters and positioning.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to 45 Years (Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Age between 18 and 45 years
- •Acute ACL injury (<6 months)
- •Medically fit for surgery
Exclusion Criteria
- •Age <18 or >45 years
- •Old or chronic ACL injuries (>6 months)
- •Multi-ligamentous knee injuries
- •Failed previous ACL reconstruction
- •Associated mal-alignment deformities
- •Absence of identifiable ACL stump
Outcomes
Primary Outcomes
Rate of Tibial Tunnel Enlargement
Time Frame: 12 months postoperatively
Secondary Outcomes
- Percentage of Tibial Tunnel Enlargement(12 months)
- Tibial Tunnel Positioning (X & Y coordinates)(2 Weeks)
- Femoral Tunnel Positioning (X & Y coordinates)(2 Weeks)
- Femoral Tunnel Diameter Change(12 months)
Investigators
Mahmoud Ahmed El-Desouky
Associate Professor of Orthopedic surgery
Cairo University