The difference in clinical outcome of single-bundle anterior cruciate ligament reconstructions with and without remnant preservation: A meta-analysis

Knee. 2016 Aug;23(4):566-74. doi: 10.1016/j.knee.2015.07.010. Epub 2016 May 17.


Background: The aim of this study was to compare the clinical performance and complications between an ACL reconstruction with a remnant-preserving single-bundle technique and a standard single-bundle technique.

Methods: A search was performed of RCTs comparing the clinical outcomes and complications of ACL reconstruction with remnant-preserving and standard single-bundle techniques during October 2014. Relevant data were extracted and CONSORT was used to assess the methodological quality. Stata/SE 12.0 was used to perform a meta-analysis of the clinical outcomes.

Results: Six RCTs were included, with a total of 378 patients: 190 in the remnant-preservation technique group and 188 patients in standard-technique group. Assessing anterior stability, no difference was found between the groups for the KT arthrometer, negative rate of Lachman, and the pivot shift test. Assessing functional outcome, there was no significant difference in IKCD scores and grades or Lysholm score. In terms of complications, the percentage of tibial tunnel enlargement in the group of the remnant-preservation technique was significantly lower, despite no significant difference in the incidence of cyclops lesions.

Conclusions: The outcome of single-bundle ACL reconstruction with the remnant-preservation technique is similar to that with the standard technique in terms of anterior stability and functional recovery of the knee. Remnant preservation in ACL reconstruction decreases the percentage of tibial tunnel enlargement. Level of evidence is II.

Keywords: Anterior cruciate ligament; Meta-analysis; Reconstruction; Remnant; Single bundle.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Anterior Cruciate Ligament / physiopathology
  • Anterior Cruciate Ligament / surgery*
  • Anterior Cruciate Ligament Injuries / physiopathology
  • Anterior Cruciate Ligament Injuries / surgery*
  • Anterior Cruciate Ligament Reconstruction / methods*
  • Arthroscopy
  • Humans
  • Joint Instability / physiopathology
  • Joint Instability / surgery
  • Knee Joint / physiopathology
  • Knee Joint / surgery
  • Randomized Controlled Trials as Topic
  • Treatment Outcome