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OpenTrials
Completed

NCT Number: NCT07236593

Remnant Preservation and Tibial Tunnel Widening After ACL Reconstruction

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.

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Key information

Conditions

Anterior Cruciate Ligament Injury Anterior Cruciate Ligament Injuries Knee Injuries Leg Injuries Wounds and Injuries

Age range

18 year–45 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Kasr Alainy

Cairo, Egypt

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

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

Exclusion criteria

  • 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

Treatment and study plan

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-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.

Primary outcomes

  1. Rate of Tibial Tunnel Enlargement

    Time frame: 12 months postoperatively

Secondary outcomes

  1. Percentage of Tibial Tunnel Enlargement

    Time frame: 12 months

  2. Tibial Tunnel Positioning (X & Y coordinates)

    Time frame: 2 Weeks

  3. Femoral Tunnel Diameter Change

    Time frame: 12 months

  4. Femoral Tunnel Positioning (X & Y coordinates)

    Time frame: 2 Weeks

Sponsors and collaborators

Lead sponsor

Cairo University

Other

Registry information

Official study title

Remnant Preservation in Anterior Cruciate Ligament Reconstruction: Does Stump Suturing Reduce the Risk of Tibial Tunnel Widening? A CT-Based Study

Important dates

Study start
2021
Primary completion
2024
Study completion
2024
First posted
Nov 19, 2025
Registry last updated
Nov 19, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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