Remnant Preservation and Tibial Tunnel Widening After ACL Reconstruction

NCT07236593 | Completed

• 1 other identifier: N-473-2021
• Study Type: interventional
• Target: 190
• Locations: 1 country
• Sites: 1

Brief Summary

Anterior Cruciate Ligament (ACL) reconstruction is one of the most commonly performed orthopedic procedures. Tibial tunnel widening is a recognized postoperative complication that may affect graft stability and long-term outcomes. Recent studies have suggested that preserving the ACL remnant may improve biological healing and reduce tunnel widening, but the evidence remains inconclusive. This prospective randomized study aims to evaluate whether remnant (stump) preservation and suturing during ACL reconstruction can reduce the risk of tibial tunnel widening compared with the conventional stump-resection technique. A total of 190 patients with recent ACL tears (\<6 months) were randomly assigned into two equal groups: Group A underwent arthroscopic ACL reconstruction with remnant suturing, while Group B underwent standard reconstruction with stump resection. All patients were followed for 12 months postoperatively with serial CT evaluations to assess tunnel diameters and positioning.

Conditions

Anterior Cruciate Ligament Injury

Outcome Measures

Primary Outcomes (1)

• Rate of Tibial Tunnel Enlargement

  12 months postoperatively

Secondary Outcomes (4)

• Percentage of Tibial Tunnel Enlargement

  12 months

• Tibial Tunnel Positioning (X & Y coordinates)

  2 Weeks

• Femoral Tunnel Diameter Change

  12 months

• Femoral Tunnel Positioning (X & Y coordinates)

  2 Weeks

Study Arms (2)

Stump-Suturing ACL Reconstruction

EXPERIMENTAL

Procedure: Stump-Suturing ACL Reconstruction

Stump-Resection ACL Reconstruction

ACTIVE COMPARATOR

Procedure: Stump-Resection ACL Reconstruction

Interventions

Stump-Suturing ACL Reconstruction PROCEDURE

Patients in this group undergo arthroscopic ACL reconstruction with preservation and suturing of the native ACL remnant (stump) around the graft. The technique aims to enhance graft revascularization and biological healing, potentially reducing tibial tunnel widening.

Stump-Suturing ACL Reconstruction

Stump-Resection ACL Reconstruction PROCEDURE

Patients in this group undergo standard arthroscopic ACL reconstruction with complete resection of the ACL remnant (stump) prior to graft placement. This represents the conventional surgical approach for ACL reconstruction.

Stump-Resection ACL Reconstruction

Eligibility Criteria

• Age: 18 Years - 45 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Age between 18 and 45 years
• Acute ACL injury (\<6 months)
• Medically fit for surgery

You may not qualify if:

• Age \<18 or \>45 years
• Old or chronic ACL injuries (\>6 months)
• Multi-ligamentous knee injuries
• Failed previous ACL reconstruction
• Associated mal-alignment deformities
• Absence of identifiable ACL stump

Sponsors & Collaborators

• Cairo University: lead

Study Sites (1)

Kasr Alainy

Cairo, Egypt

Location

MeSH Terms

Conditions

Anterior Cruciate Ligament Injuries

Condition Hierarchy (Ancestors)

Knee Injuries; Leg Injuries; Wounds and Injuries

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor of Orthopedic surgery

Study Record Dates

• First Submitted: November 15, 2025
• First Posted: November 19, 2025
• Study Start: July 1, 2021
• Primary Completion: March 30, 2024
• Study Completion: March 30, 2024
• Last Updated: November 19, 2025

Record last verified: 2025-11

Locations

EG (1)