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Published on: April 30, 2014
Partial ACL reconstruction with preservation of the posterolateral bundle
B Sonnery-Cottet1, J-C Panisset, P Colombet
1Centre orthopédique Paul-Santy, 24, avenue Paul-Santy, 69008 Lyon, France. sonnerycottet@aol.com
Orthopaedics & Traumatology, Surgery & Research : OTSR
|November 13, 2012
Summary
Selective anterior cruciate ligament (ACL) reconstruction effectively restores knee stability and function in partial tears by preserving residual fibers. This technique, focusing on the anteromedial bundle, shows significant improvements in patient outcomes.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Biomedical Engineering
Background:
- Evolving understanding of anterior cruciate ligament (ACL) anatomy and function.
- Development of selective reconstruction techniques for partial ACL tears.
- Hypothesis: Selective bundle reconstruction can restore knee stability and function.
Purpose of the Study:
- To evaluate the efficacy of selective anteromedial (AM) bundle ACL reconstruction with posterolateral (PL) bundle preservation.
- To assess clinical outcomes and knee laxity following this procedure.
- To compare pre- and postoperative functional and stability measures.
Main Methods:
- Multicenter retrospective study of 168 patients with partial ACL tears.
- Selective AM bundle reconstruction preserving the PL bundle.
- Clinical evaluation using IKDC and Lysholm scores.
- Instrumental laxity measurement via arthrometer and stress radiography.
Main Results:
- Significant improvement in subjective IKDC scores (63.7 to 90.5, P<0.001).
- Significant improvement in Lysholm scores (80 to 95.5, P<0.001).
- Improved objective IKDC scores, with 92% classified A or B postoperatively.
- Reduced knee laxity from 5.5mm to 1.1mm (P<0.00001).
Conclusions:
- Selective AM bundle ACL reconstruction with PL bundle preservation effectively restores knee stability and function.
- The technique demonstrates significant improvements in patient-reported outcomes and objective knee stability.
- Careful graft sizing is crucial to prevent intercondylar notch impingement.
