A Pilot Study of Anatomic Double-Bundle Anterior Cruciate Ligament Reconstruction With Ligament Remnant Tissue Preservation

Purpose The purpose of this pilot study was to evaluate the preliminary results of an anatomic double-bundle anterior cruciate ligament (ACL) reconstruction procedure with ligament remnant tissue preservation. Methods By use of the transtibial technique, 2 doubled semitendinosus tendons were grafted into 4 tunnels created at the center of each bundle attachment, penetrating the ACL remnant tissue. In total, 44 patients (27 male and 17 female patients) with an isolated ACL injury underwent ACL reconstruction with this procedure. The mean age of the patients was 29 years (range, 17 to 58 years). Postoperative clinical evaluations were performed at 16.6 months on average (range, 12 to 23 months). Radiologic evaluations were also performed to evaluate the tunnel location in the femur and the tibia. Results The mean operation time was 86 minutes (range, 72 to 96 minutes) in the cases with ACL reconstruction only. Postoperatively, the mean anterior laxity was 0.7 mm. The postoperative pivot-shift test was negative in 81.8% of the patients, whereas there were no patients evaluated as ++. No patients showed any extension or flexion deficit. There were no patients evaluated as “nearly abnormal” or “abnormal” according to the International Knee Documentation Committee evaluation. The tunnel angles of the 4 tunnels were identical to those reported in a previous study. Conclusions The minimal 1-year clinical results of anatomic double-bundle ACL reconstruction with ligament remnant tissue preservation were comparable to previously reported results of anatomic double-bundle reconstruction without remnant tissue preservation. Level of Evidence Level IV, therapeutic case series.