Anterior Cruciate Ligament Injury
Conditions
Brief summary
Anterior Cruciate Ligament (ACL) reconstruction is one of the most commonly performed orthopedic procedures. Tibial tunnel widening is a recognized postoperative complication that may affect graft stability and long-term outcomes. Recent studies have suggested that preserving the ACL remnant may improve biological healing and reduce tunnel widening, but the evidence remains inconclusive. This prospective randomized study aims to evaluate whether remnant (stump) preservation and suturing during ACL reconstruction can reduce the risk of tibial tunnel widening compared with the conventional stump-resection technique. A total of 190 patients with recent ACL tears (\<6 months) were randomly assigned into two equal groups: Group A underwent arthroscopic ACL reconstruction with remnant suturing, while Group B underwent standard reconstruction with stump resection. All patients were followed for 12 months postoperatively with serial CT evaluations to assess tunnel diameters and positioning.
Interventions
PROCEDUREStump-Suturing ACL Reconstruction
Patients in this group undergo arthroscopic ACL reconstruction with preservation and suturing of the native ACL remnant (stump) around the graft. The technique aims to enhance graft revascularization and biological healing, potentially reducing tibial tunnel widening.
PROCEDUREStump-Resection ACL Reconstruction
Patients in this group undergo standard arthroscopic ACL reconstruction with complete resection of the ACL remnant (stump) prior to graft placement. This represents the conventional surgical approach for ACL reconstruction.
Sponsors
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
* Age between 18 and 45 years * Acute ACL injury (\<6 months) * Medically fit for surgery
Exclusion criteria
* Age \<18 or \>45 years * Old or chronic ACL injuries (\>6 months) * Multi-ligamentous knee injuries * Failed previous ACL reconstruction * Associated mal-alignment deformities * Absence of identifiable ACL stump
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Rate of Tibial Tunnel Enlargement | 12 months postoperatively |
Secondary
| Measure | Time frame |
|---|---|
| Percentage of Tibial Tunnel Enlargement | 12 months |
| Tibial Tunnel Positioning (X & Y coordinates) | 2 Weeks |
| Femoral Tunnel Diameter Change | 12 months |
| Femoral Tunnel Positioning (X & Y coordinates) | 2 Weeks |
Countries
Egypt
Outcome results
None listed