Purpose. This is a systematic review and meta-analysis of current evidence that aims at comparing the clinical outcomes of remnant-preserving anterior cruciate ligament reconstruction (ACLR) and standard ACLR. Methods. A systematic review of randomized controlled studies and cohort studies comparing remnant-preserving ACLR with standard ACLR with a minimum level of evidence of II was performed. Studies were included by strict inclusion and exclusion criteria. Extracted data were summarized as preoperative conditions, postoperative clinical outcomes, and postoperative complications. When feasible, meta-analysis was performed with RevMan5.3 software. Study methodological quality was evaluated with the modified Coleman methodology score (CMS). Results. Eleven studies (n = 466 remnant-preserving and n = 536 standard) met the inclusion criteria. The mean modified CMS for all included studies was 85.8 (range: 77–92 on a 100-point scale). In total, 466 patients underwent remnant-preserving ACLR by 3 different procedures: standard ACLR plus tibial remnant tensioning (n = 283), selective-bundle augmentation (n = 49), and standard ACLR plus tibial remnant sparing (n = 134). Remnant-preserving ACLR provided a superior outcome of postoperative knee anterior stability (WMD = −0.42, 95% CI, −0.66, −0.17; ) and Lysholm score (WMD = 2.01, 95% CI, 0.53 to 3.50; ). There was no significant difference between the two groups with respect to second-look arthroscopy (OR = 1.38, 95% CI, 0.53, 3.62; ), complications (OR = 1.24 95% CI, 0.76, 2.02; ), International Knee Documentation Committee (IKDC) subject scores, IKDC grades, Lachman test, and pivot-shift test. Summary/conclusion. Remnant-preserving ACLR promotes similar graft synovial coverage and revascularization to standard ACLR. Equivalent or superior postoperative knee stability and clinical scores were observed for remnant-preserving ACLR compared with standard ACLR. No significant difference in the total complication rate between the groups was evident.

中文翻译：

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前交叉韧带重建中的残余物保留优于标准技术吗？系统评价和荟萃分析

目的。这是对当前证据的系统评价和荟萃分析，旨在比较保留残余前交叉韧带重建 (ACLR) 和标准 ACLR 的临床结果。方法。对随机对照研究和队列研究进行了系统评价，比较了保留残留的 ACLR 与标准 ACLR，最低证据水平为 II。研究按严格的纳入和排除标准纳入。提取的数据总结为术前情况、术后临床结果和术后并发症。在可行的情况下，使用 RevMan5.3 软件进行荟萃分析。研究方法学质量使用改良的 Coleman 方法学评分 (CMS) 进行评估。结果。十一研究（n  = 466 残存和n  = 536 标准）符合纳入标准。所有纳入研究的平均修正 CMS 为 85.8（范围：77-92，100 分制）。总共有 466 名患者通过 3 种不同的程序接受了保留残余 ACLR：标准 ACLR 加胫骨残余张力 ( n  = 283)、选择性束增强 ( n  = 49) 和标准 ACLR 加胫骨残余保留 ( n  = 134)。保留残余的 ACLR 在术后膝关节前部稳定性（WMD = -0.42, 95% CI, -0.66, -0.17; ）和 Lysholm 评分（WMD = 2.01, 95% CI, 0.53 至 3.50; ）方面提供了更好的结果。两组在二次关节镜检查（OR = 1.38, 95% CI, 0.53, 3.62; ）、并发症（OR = 1.24 95% CI, 0.76, 2.02; ）方面无显着差异，国际膝关节文献委员会(IKDC) 科目成绩、IKDC 成绩、Lachman 测试和枢轴移位测试。总结/结论。保留残余的 ACLR 促进与标准 ACLR 相似的移植滑膜覆盖和血运重建。与标准 ACLR 相比，保留残余 ACLR 的术后膝关节稳定性和临床评分相同或更高。组间总并发症发生率无显着差异。