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Background:   Remnant-preserving anterior cruciate ligament (ACL) reconstruction was introduced to improve clinical outcomes and biological healing. However, the influences of remnant preservation on tibial tunnel position and enlargement are still uncertain.Purpose:   To evaluate whether remnant-preserving ACL reconstruction influences tibial tunnel position or enlargement and to examine the relationship between tunnel enlargement and graft-to-bone integration in the tibial tunnel.Study Design:   Cohort study; Level of evidence, 2.Methods:   A total of 91 knees with double-bundle ACL reconstructions were enrolled in this study. ACL reconstruction was performed without a remnant (  .05). The degree of posterolateral tunnel enlargement in the axial plane was significantly higher in the RP group than that in the NR group ( P = .007) 1 year after ACL reconstruction. The degree of anteromedial tunnel enlargement on axial CT was significantly smaller in knees with graft-to-bone integration than in those without integration ( P = .002) 1 year after ACL reconstruction.Conclusion:   ACL reconstruction with remnant preservation did not influence tibial tunnel position and did not decrease the degree or incidence of tibial tunnel enlargement. At 1 year postoperatively, tunnel enlargement did not affect graft-to-bone integration in the posterolateral tunnel, but graft-to-bone integration was delayed in the anteromedial tunnel.

orthopaedic journal of sports medicine

Does Remnant Preservation Influence Tibial Tunnel Enlargement or Graft-to-Bone Integration After Double-Bundle Anterior Cruciate Ligament Reconstruction Using Hamstring Autografts and Suspensory Fixation? A Computed Tomography and Magnetic Resonance Imaging Evaluation