Anterior Cruciate Ligament Hybrid Remnant Preservation Reconstruction Demonstrates Similar Outcomes as Traditional Reconstruction after 6 Months: A Randomized Control Trial

Background The anterior cruciate ligament (ACL) is often debrided during reconstruction (ACLR) to improve visualization. However, remnant ACL tissue contains nerve fibers and including remnant tissue in ACLR could provide benefit. Therefore, a technique was developed that preserves the tibial remnant and incorporates it into ACLR: Hybrid Remnant Preservation Reconstruction (HRPR) ACLR. This study compares HRPR-ACLR to traditional reconstruction by comparing patient reported outcomes and complications. Methods Patients presenting to one surgeon\u27s clinic with an ACL injury are screened. Exclusion criteria are patient age\u3c14 years, multi-ligament injury, chronic tears, and revision ACLR. Patients are consented and randomized to HRPR or traditional ACLR. Demographics, patient-reported outcomes, range of motion (ROM) and complications were collected. Results Thirty-three patients were included, 20 HRPR and 13 controls. No demographic differences were noted. PROMIS-PF, PROMIS-PI, IKDC and PASS scores were equivalent. HRPR reported higher PROMIS-D scores at 6 months (41.90 ± 8.52 vs 34.92 ± 3.33, p=0.009). HRPR demonstrated significantly increased ROM in the affected (137.81 ± 9.69 vs. 127.33 ± 14.82, p=0.05) and unaffected (144.06 ± 9.26 vs 135.25 ± 7.34, p=0.01) legs after 3 months. No ROM difference existed after 6 months in the affected leg (139.0 ± 8.46 vs 131.0 ± 13.42, p=0.07) although a difference existed in the unaffected leg (142.32 ± 8.27 vs 135.62 ± 7.69, p=0.03). Two control group patients suffered complications compared to zero HRPR (p=0.07). Conclusion HRPR-ACLR demonstrates similar patient-reported outcomes and significantly increased range of motion without increased complications compared to traditional ACLR after 6 months

Anterior Cruciate Ligament Hybrid Remnant Preservation Reconstruction Demonstrates Equivalent Patient-Reported Outcomes and Complications as Traditional Anterior Cruciate Ligament Reconstruction After 1 Year

Purpose: To compare the outcomes of anterior cruciate ligament (ACL) Hybrid Remnant Preservation Reconstruction (HRPR) with traditional anterior cruciate ligament reconstruction (ACLR) and determine differences in patient-reported outcomes, range of motion (ROM), and complications after 12 months. Methods: A retrospective cohort study of patients undergoing ACLR by a single surgeon from December 2020 to January 2022 was conducted. Patients undergoing ACL-HRPR were compared with control patients undergoing traditional ACLR with bone−patellar tendon−bone autograft. Preoperative and postoperative Patient-Reported Outcome Measurement Information System scores, International Knee Documentation Committee, and patient acceptable symptom state were recorded over 12 months. Any complications occurring 12 months postoperatively were collected. Results: The final analysis included 104 patients, with 39 undergoing ACL-HRPR compared with 65 ACLR controls. Patients who received HRPR were on average 19.46 ± 5.01 years old, with 51.28% being female, whereas control patients were, on average, 21.92 ± 7.71 years old with 50.77% being female. Total ROM was equivalent between groups, with complete terminal extension at 12 months. No significant differences were found for patient acceptable symptom state; Patient-Reported Outcome Measurement Information System-Physical Function, -Pain Interference, or -Depression; or International Knee Documentation Committee at 6 months and 12 months postoperatively. Total ROM was similar between the HRPR and control groups. No differences were found for timed 6-meter hop test, hop for distance, or KT-1000 side-to-side differences. Over the 12-month period, complication rates were similar between groups (10% vs 12% P = .75) were similar. Conclusions: ACL HRPR is associated with equivalent patient-reported outcomes, full ROM, and no differences in complications rates after 1 year compared with control patients in the present retrospective study. Level of Evidence: Level III, retrospective cohort study