{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T00:57:09Z","timestamp":1793235429841,"version":"4.5.0"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2012,12,15]],"date-time":"2012-12-15T00:00:00Z","timestamp":1355529600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To investigate the effect of remnant preservation on tibial tunnel enlargement in a single\u2010bundle anterior cruciate ligament (ACL) reconstruction with a hamstring autograft.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From 2006 to 2009, a total of 62 patients who underwent single\u2010bundle ACL reconstruction with a quadrupled hamstring tendon autograft were enrolled in this study. The patients were randomly divided into two groups: the preserving\u2010remnant group and the removing\u2010remnant group. Plain radiographs were taken at 1 week, and 3, 6, and 24\u00a0months postoperatively, and tibial tunnel enlargement was evaluated. The postoperative clinical assessment included the Lysholm rating scale and KT\u20101000\u00a0measurement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 27 patients in the preserving\u2010remnant group and 24 patients in the removing\u2010remnant group were followed up and the median follow\u2010up was 24.5\u00a0months (range 24\u201327\u00a0months). Tibial tunnel enlargement occurred within 6\u00a0months postoperatively. Positive enlargement was observed in 8 patients (29.6 %) in the preserving\u2010remnant group and 14 patients (58.3 %) in the removing\u2010remnant group (<jats:italic>P<\/jats:italic> = 0.0388). The percentage of tibial tunnel enlargement was 25.7 \u00b1 6.7 and 34.0 \u00b1 8.9 % in the preserving\u2010 and removing\u2010remnant groups, respectively (<jats:italic>P<\/jats:italic> = 0.0004). In the preserving\u2010remnant group, the average Lysholm score increased from 60.3 \u00b1 5.3 (51\u201369) to 93.0 \u00b1 3.5 (88\u2013100), and the side\u2010to\u2010side difference of the KT\u20101000 changed from 6.3 \u00b1 0.9 (5.1\u20138.0) to 1.4 \u00b1 0.6 (0.5\u20132.4) mm. In the removing\u2010remnant group, the average Lysholm score increased from 58.7 \u00b1 6.5 (48\u201371) to 91.1 \u00b1 3.9 (85\u2013100), and the side\u2010to\u2010side difference of the KT\u20101000 changed from 6.5 \u00b1 0.8 (5.4\u20138.2) to 1.7 \u00b1 0.6 (0.6\u20132.8) mm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>It is confirmed that remnant preservation in ACL reconstruction can resist tibial tunnel enlargement but that this technique does not affect the short\u2010term clinical outcome of ACL reconstruction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>I.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-012-2341-7","type":"journal-article","created":{"date-parts":[[2012,12,13]],"date-time":"2012-12-13T22:42:54Z","timestamp":1355438574000},"page":"166-173","source":"Crossref","is-referenced-by-count":75,"title":["The effect of remnant preservation on tibial tunnel enlargement in ACL reconstruction with hamstring autograft: a prospective randomized controlled trial"],"prefix":"10.1002","volume":"22","author":[{"given":"Qiang","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Orthapaedic Surgery The General Hospital of the Jinan Military Command No. 25, Shifan Road Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthapaedic Surgery The General Hospital of the Jinan Military Command No. 25, Shifan Road Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuecheng","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Orthapaedic Surgery The General Hospital of the Jinan Military Command No. 25, Shifan Road Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lifeng","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthapaedic Surgery The General Hospital of the Jinan Military Command No. 25, Shifan Road Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthapaedic Surgery The General Hospital of the Jinan Military Command No. 25, Shifan Road Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthapaedic Surgery The General Hospital of the Jinan Military Command No. 25, Shifan Road Jinan Shandong China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,12,15]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402\u2010008\u20100597\u20107"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2011.03.002"},{"key":"e_1_2_7_4_1","first-page":"47","article-title":"Diagnosing and managing anterior cruciate ligament injuries","volume":"17","author":"Cameron ML","year":"2000","journal-title":"J Musculoskelet"},{"key":"e_1_2_7_5_1","first-page":"917","article-title":"Anterior cruciate ligament injury: diagnosis, management, and prevention","volume":"82","author":"Cimino F","year":"2010","journal-title":"Am Fam 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tunnel enlargement after arthroscopic ACL reconstructions","volume":"73","author":"Ugutmen E","year":"2007","journal-title":"Acta Orthop Belg"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546504263151"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2011.01.015"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2011.10.035"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2011.02.020"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1053\/jars.2002.25966"},{"key":"e_1_2_7_30_1","first-page":"320","article-title":"Relationship between tunnel widening and different rehabilitation procedures after anterior cruciate ligament reconstruction with quadrupled hamstring tendons","volume":"118","author":"Yu JK","year":"2005","journal-title":"Chin Med 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