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Remnant preservation in anterior cruciate ligament reconstruction versus standard techniques: a meta-analysis of randomized controlled trials.

INTRODUCTION
Preserving the remnant during anterior cruciate ligament (ACL) reconstruction is considered beneficial for graft healing, but it might increase the technical difficulties and complications. This study was to compare outcomes of using the technique of remnant preservation during the ACL reconstruction versus the standard procedure with the debridement of remnant.


EVIDENCE ACQUISITION
We searched PubMed and EMBASE and the Cochrane Library for randomized controlled trials comparing the outcomes of ACL reconstruction both with and without remnant preservation. The risk of bias was assessed in accordance with the Cochrane Collaboration's risk of bias tool. Meta-analysis was performed to compare results.


EVIDENCE SYNTHESIS
Six randomized controlled trials with 346 patients were included. Statistically signiﬁcant differences in favor of using technique of remnant preservation were observed for Lysholm Score, arthrometer measurements, and tibial tunnel enlargement. There was no signiﬁcant difference between remnant technique of preservation and the standard procedure with respect to the IKDC (International Knee Documentation Committee) grade, IKDC score, Lachman Test, Pivot-shift Test, range of motion (ROM), and the incidence of the cyclops lesion.


CONCLUSIONS
This meta-analysis of randomized controlled trials showed that ACL reconstruction with technique of remnant preservation cannot provide superior clinical outcomes compared with the standard procedure.