Research Advances in Anterior Cruciate Ligament Reconstructions with Remnant Preservation: A Review Article
Shashi Ranjan Tiwari, Biao Cheng*
Department of Orthopedic, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, PR China.
This review summarizes the methods and research progress of reconstruction of the anterior cruciate ligament with the remnant preservation technique under arthroscopy for clinic reference. The related literature on the reconstruction of ACL with the remnant preservation technique under arthroscopy in recent years was reviewed and analyzed synthetically. There are some fibers left after the ACL injury, and that residual fiber could be divided into two types: residual bundle and residual stump. There are a number of techniques for reconstructing ACL under arthroscopy, including a single bundle of reconstructed remnants, retention of the tibia stump and recovery of stump structure by appropriate techniques. The preserved remnant provided synovium for the reconstructed ACL, which could accelerate revascularization of the graft, and be a benefit for the recovery of proprioception, besides the certain kinds of remnant could contribute to the stability of the knee joint, which can block the synovial fluid into the tunnel and prevent the tunnel to expand. However, the reconstruction of ACL surgery with the remnant preservation requires the high technique of surgery for the surgeon. At the same time, intercondylar notch impact and cyclops deformity and other complications may occur after surgery. The reconstruction of ACL with the remnant preservation can obtain a better clinical curative result, but the operation is difficult, the surgeon has high technical requirements. There should be more relevant basic research and clinical randomized controlled trials about remnant preservation in ACL reconstruction, which still need further study of its necessity and advantages and disadvantages.