The Magnetic Resonance Imaging And Clinical Efficacy After Reconstruction Of Anterior Cruciate Ligament With Tibial Remnants Preservation

BlackgroupIt is held in modern medical science that Anterior Cruciate Ligament (ACL) plays a significant supporting role in the stability of the knee joint. A good reconstruction surgery brings crucial impact on the recovery function after ACL injury. Therefore, the arthroscopic ACL reconstruction technique has been widely practiced and continuously developed. The current dispute in this area lies in whether to retain the remnant of ACL, which, exerts its major function in the rapid growth of tiny blood vessels, nerves and mechanoreceptors for the reconstructed ACL. Although the arthroscopic examination and histopathology are valued as the gold standard for diagnosis of the reconstructed ACL, these invasive treatment methods, due to various problems, have not gained adequate support yet. Many clinical reseach had proved the advantage of remnant-preservated reconstruction with Lysholm and IKDC score. However, the clinical score was so subjective that there were too many irregular results. If we focus on MRI characteristic after ACL reconstruction, maybe we can find out the advantage of remnant-preservated technique.ObjectivesThe study aims at exploring the potential impact of remnant-preserving on reconstruction of ACL, by means of literature review of case analyses, comparison of both the Magnetic Resonance Imaging (MRI) and clinical scores between remnant-preserving and non-preserving.MethodsThe research focuses on the patients having operations of ACL reconstruction in Guangdong Provincial Hospital of Traditional Chinese Medicine over the period from January2011to March2013. According to the operation records, the research subjects were divided into two groups, i.e. remnant-preserving group (test group) and non-preserving group (control group), between which a comparison was made, based on the records of clinical scores before operations and the MRI evaluation results and clinical scores three months after,6months after and12months after operations.ResultsAll of the relevant data, including, age, gender, sick area, time of operation, direction of bone tunnels, size of original bones, follow-up periods, the objective clinical scores of Lysholm of the knee joints together with the subjective clinical scores of IKDC before surgery, reveal no difference between both research groups and thus demonstrates comparability. The course of disease in non-preserving group is longer than the other group. In the follow-ups of both groups of patients, the followings are found:1. preservation of remnants is correlated with illness;2. Six months after surgery, the stability objective clinical scores of Lysholm, staircase climbing item and overall score of the research groups start to diverse, with the remnant-preserving group demonstrating better performances;3. The expansion rates of graft and bone tunnel, as well as SNR show differences of various degrees3,6and12months after surgery, with the remnant-preserving group demonstrating better performances.ConclusionA retrospective analysis found that an in-time treatment in the early stage of ACL injury has important influence on remnant preservation. After the reconstruction ACL with remnant preserved, patients can improve muscle strength around the joint in the recovery period, accelerate the remodeling process of graft, slow down the expansion of the bone tunnel, reduce the incidence of graft loosening, promote rehabilitation after surgery, which lays a solid theoretical foundation by the remnant-preserving ACL reconstruction technique.