Remnant Preservation and Tibial Tunnel Widening After ACL Reconstruction

Cairo University190 enrolled

Overview

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.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

190

Conditions

Anterior Cruciate Ligament Injury

Interventions

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.

Stump-Resection ACL ReconstructionPROCEDURE

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.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 45 Years

Medical Language ↔ Plain English

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

Locations (1)

Kasr Alainy

Cairo, Egypt

Outcomes

Primary Outcomes

Rate of Tibial Tunnel Enlargement

Time frame: 12 months postoperatively

Secondary Outcomes

Percentage of Tibial Tunnel Enlargement

Time frame: 12 months

Tibial Tunnel Positioning (X & Y coordinates)

Time frame: 2 Weeks

Femoral Tunnel Diameter Change

Time frame: 12 months

Femoral Tunnel Positioning (X & Y coordinates)

Time frame: 2 Weeks

Data from ClinicalTrials.gov

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