Effects of Femoral Remnant Preservation During Anterior Cruciate Ligament Reconstruction on the Clinical and Functional Outcomes

Background: The aim of this study is to compare the functional and clinical results of the femoral remnant-sparing reconstruction technique with the standard technique in the surgical reconstruction of anterior cruciate ligament (ACL) tears.Materials and Methods: 150 patients (all men) who underwent surgery for ACL tear were included in the pros-pective randomized study. The patients were randomly divided into two groups. In Group A (n=75), ACL reconst-ruction with preservation of tibial and femoral remnants was performed using hamstring tendon autograft. In group B (n=75), standard reconstruction technique was performed with hamstring tendon autograft and femoral remnants were removed while tibial remnants were preserved. The mean age of patients in Group A was 27.23±5.64 years, and 26.72±5.82 years in Group B. The interval between trauma and operation was 4.36±3.21 months in Group A and 3.56±3.08 months in Group B. The mean follow-up period of the patients was 38.05±6.11 months for Group A and 36.86±8.04 months for Group B. There was no difference between the two groups in terms of age of the patients, interval between trauma and operation and follow-up periods (p˃0.05). Clinical outcomes of surgery were evaluated using Lysholm score, International Knee Documentation Committee (IKDC) score, Subjective IKDC 2000 knee score, and physical instability tests.Results: Statistically significant improvement was detected in the preoperative Lysholm, subjective and objective IKDC knee scores, joint range of motion and knee stability tests (Lachman, Pivot Shift, Anterior Drawer) of Group A and Group B patients (p<0.001). When preoperative and postoperative comparisons were made between the groups in early (18 months) controls, a significant increase was found in favor of Group A in Lysholm, subjective and objective IKDC knee scores (p˂0.05). There were no significant differences in Lysholm, subjective and objecti-ve IKDC knee scores, joint range of motion, and knee stability tests (Lachman, Pivot Shift, Forward drawer) at the last follow-up of the patients (p˃0.05).Conclusions: In the surgical reconstruction of ACL tears, the histologically determined theoretical contribution of ACL femoral remnants in ACL reconstruction performed by preserving the femoral remnants is not clearly obser-ved in clinical and functional results.