Remnant-preserving and re-tensioning technique to cover the graft in anterior cruciate ligament reconstruction

Jung Ho Noh, Hee Soo Kyung, Young Hak Roh, Tae Seok Kang

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Purpose: This study set out to assess the clinical and radiographic outcomes and the extent of synovial coverage on second-look arthroscopy of anterior cruciate ligament (ACL) reconstruction using a remnant-preserving and re-tensioning technique to easily cover the graft with a remnant. Methods: Forty-three subjects with ACL rupture underwent remnant-preserving and re-tensioning ACL reconstruction using a free tendon Achilles allograft between 2011 and 2013. The clinical outcomes were assessed by Lysholm knee score, Lachman stress test, pivot shift test, International Knee Documentation Committee (IKDC) classification, and Tegner Activity Scale score. Side-to-side difference (SSD) was assessed on stress radiographs. The extent of synovialization was evaluated on second-look arthroscopy. Results: The mean Lysholm score was 54 ± 11 before surgery and 94 ± 5 at the last follow-up (p < 0.001). On Lachman stress test, 42 subjects had grade 0 or 1 on the Lachman stress test, and 42 had grade 0 or 1 on the pivot shift test. Forty-one subjects had IKDC classification A or B; two were classified as C or D. The median Tegner Activity Scale score was 6.5 (range 5–9) before injury and 6 (range 4–8) at the last follow-up (p = 0.048). Mean SSD on stress radiographs was 9.9 ± 2.6 mm preoperatively and 1.0 ± 1.7 mm at the last follow-up (p < 0.001). In the assessment of the extent of synovial coverage of the graft, 39 subjects were in group 1 (>75 %) for synovial coverage of the graft, three were in group 2 (50–75 %), and one was in group 4 (≤25 %). Conclusions: The remnant-preserving and re-tensioning technique resulted in satisfying short-term results clinically and radiologically and good synovial coverage on second-look arthroscopy. Level of Evidence: Case series, Level IV.

Original languageEnglish
Pages (from-to)1205-1210
Number of pages6
JournalKnee Surgery, Sports Traumatology, Arthroscopy
Issue number4
StatePublished - 1 Apr 2017

Bibliographical note

Funding Information:
This study was supported by 2014 Research Grant from Kangwon National University (No. 120141480).

Publisher Copyright:
© 2015, European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).


  • Anterior
  • Cruciate
  • Knee
  • Ligament
  • Re-tensioning
  • Remnant


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