Arthroscopic ACL reconstruction: a 5–9 year follow-up

doi:10.1016/S0968-0160(02)00019-4

The Knee

Volume 9, Issue 3, September 2002, Pages 197-200

https://doi.org/10.1016/S0968-0160(02)00019-4 Get rights and content

Abstract

Arthroscopic ACL reconstruction has a satisfactory functional outcome of up to 90%, but there are few long-term prospective studies. This prospective study presents the outcomes of ACL reconstruction in terms of laxity, function and degenerative change, after a mean follow-up of 7 years. Function was assessed using the Lysholm and Tegner Activity Scores, laxity using the Stryker Knee Laxity Tester, employing maximum manual effort, and degenerative change was assessed as joint line narrowing on standardised radiographs. At latest follow-up, the mean Lysholm score improved from 70 to 87 and the Tegner from 4 to 7 (P<0.001). AP translation also improved (P<0.001). The incidence of early degenerative change was 50% and although this appeared to be associated with a previous meniscectomy, the correlation was not significant (P=0.06). In conclusion, the improved functional scores and laxity are sustained beyond 7 years but the 50% incidence of early degenerative change may be a cause for concern.

Introduction

Arthroscopic reconstruction of the anterior cruciate ligament (ACL) with autologous tendon grafts results in a satisfactory outcome in up to 90% of patients [1], [6], [11]. Most current data are retrospective, with few prospective studies. Only one study provides prospective data beyond 5 years [13].

We report on the outcomes in 30 patients, followed up prospectively after arthroscopic ACL reconstruction for a minimum of 5 years. The purpose of this study was to determine if the satisfactory results of ACL reconstruction are maintained beyond 5 years and to assess the incidence of degenerative change.

Section snippets

Materials and methods

This is a prospective cohort study, looking at 90 patients undergoing arthroscopic ACL reconstruction, between 1991 and 1995 (minimum 5 years post surgery). An independent assessor evaluated each patient at the surgical pre-assessment clinic, 1 week prior to operation and at latest follow-up. All reconstructions were performed by one surgeon (RWN). Follow-up was by invitation to an outpatient clinic during a period of recall, from September 2000 to March 2001.

All patients were asked to report

Results

The details of the patients in the cohort are shown in Table 1. At 7 years, 12 patients had made a change in their first choice sport. In no case was this attributed to the knee pathology alone. Only one person changed their employment from manual to sedentary work due to their knee.

The findings on examination of the knee are summarised in Table 2. At follow-up only three patients gave a history of instability.

The functional assessments demonstrated an improvement at 7 years. Fig. 1, Fig. 2

Discussion

Restoration of the normal biomechanics of the knee with reconstruction of the deficient ACL is believed to improve the long-term function [6]. There are, however, few prospective studies. Up to 5 years, Deehan et al. [6] have reported 90% good or excellent function and Jomha et al/ [13] suggested that successful outcome is maintained at 7 years, with 81% satisfactory results. In this study, we prospectively recorded knee function and laxity at a mean follow-up of 7 years (minimum 5 years).

The

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View full text

Arthroscopic ACL reconstruction: a 5–9 year follow-up

Abstract

Introduction

Section snippets

Materials and methods

Results

Discussion

Knee

Patellar tendon versus doubled semitendinosus and gracilis tendons for anterior cruciate ligament reconstruction

Am J Sport Med

Arthrometric evaluation of knees that have a torn anterior cruciate ligament

J Bone Jt Surg

Fate of the ACL-injured patient

Am J Sport Med

Instrumented measures of anterior knee laxity in patients with acute anterior cruciate ligament disruption

Am J Sports Med

Instrumented measurement of anterior laxity of the knee

J Bone Jt Surg, (A)

Endoscopic reconstruction of the anterior cruciate ligament with an ipsilateral patellar tendon autograft

J Bone Jt Surg

Current trends in anterior cruciate ligament reconstruction. Part I. Biology and biomechanics of reconstruction

Am J Sport Med