Remnant-preserving anterior cruciate ligament reconstruction enhances proprioceptive recovery and functional outcomes: A retrospective analysis

Background: Injuries to the anterior cruciate ligament (ACL) are prevalent among athletes and those who are physically active. Although ACL reconstruction (ACLR) effectively restores mechanical stability, the preservation of remnants to improve proprioceptive recovery is an increasingly important topic. This study seeks to assess how remnant preservation during ACLR affects proprioceptive recovery, utilizing functional knee scoring systems and several proprioceptive tests, including joint position sense (JPS). Methods: This retrospective case series included 62 patients who underwent ACLR using remnant-preserving techniques. All surgeries were performed using arthroscopic single-bundle reconstruction with 4-fold hamstring autografts. Patients were followed up for 12 months postoperatively. Proprioception recovery was evaluated using JPS at 20°, 50°, and 70° knee angles, and clinical outcome was assessed using functional knee scoring systems, including the Tegner-Lysholm scoring system score and the International Knee Documentation Committee (IKDC) subjective knee evaluation form at 3, 6, and 12 months postoperatively. Results: Significant improvement was observed in Lysholm (pre-op: 54.1–90.6 at 12 months) and IKDC scores (pre-op: 45.3–87.4 at 12 months; P < 0.05). Mean JPS error reduced from 5.13° to 2.23°, suggesting enhanced proprioceptive recovery. Conclusion: Remnant preservation during ACLR appears to positively influence proprioception recovery, as reflected in superior outcomes on proprioceptive tests and functional knee scoring systems. These findings support the potential benefits of incorporating remnant-preserving techniques in ACLR protocols to enhance neurosensory restoration and functional rehabilitation.