Effect of Remnant Continuity on Postoperative Outcomes After Remnant Tensioning Anterior Cruciate Ligament Reconstruction in Respect to Clinical, Radiological, and Second-Look Arthroscopic Criteria.

Background: Remnant tensioning (RT) anterior cruciate ligament (ACL) reconstruction has been reported to have excellent postoperative outcomes for femoral-side tears. However, the influence of remnant continuity (RC) on the postoperative results after RT ACL reconstruction remains unclear. Purpose: To investigate the effects of RC on the postoperative clinical, radiological, and second-look arthroscopic outcomes after RT ACL reconstruction for femoral-side ACL tears. Study Design: Cohort study; Level of evidence, 3. Methods: This study included 94 patients who underwent RT ACL reconstruction using the hamstring tendon for femoral-side ACL tears between 2015 and 2020. The patients were divided into 2 groups according to the continuity of the remnant tissue: RC (n = 50) and remnant discontinuity (RD) (n = 44). Stability tests, including the Lachman and pivot-shift tests, side-to-side difference on Telos stress radiographs and KT-2000 arthrometer, patient-reported outcome measurements (PROMs), and graft status on postoperative magnetic resonance imaging (MRI) and second-look arthroscopy were evaluated. Results: Results of all stability tests and PROMs significantly improved postoperatively. The mean follow-up periods were 35.3 and 36.8 months in the RC and RD group, respectively. The 2 groups showed no statistically significant differences in stability outcomes or PROMs. Furthermore, the RC and RD groups showed comparable postoperative graft status on postoperative MRI and second-look arthroscopy. Conclusion: RT ACL reconstruction for RD between the femoral insertion site and ACL tissue showed comparable postoperative outcomes, including stability test, PROMs, postoperative MRI, and second-look arthroscopic data, to surgery for RC in femoral-side tears.