The role of arthroscopic debridement after anterior cruciate ligament reconstruction.
This retrospective study included 55 patients who had prior anterior cruciate ligament (ACL) reconstruction; 30 made up the experimental group who had arthroscopic debridement of impinging soft tissue and 25, who did not have a second-look arthroscopy, were used as controls. Impinging tissue was not necessarily the primary reason for arthroscopy in the experimental group. Only nine patients (30%) were debrided solely because of anterior symptoms suggestive of soft tissue impingement; 16 (53%) underwent arthroscopy primarily to assess meniscal repairs; five (17%) were done in conjunction with hardware removal. Both groups were evaluated for pain, crepitation, and anterior laxity at three specific times. Debridement reduced crepitation from 35% to 8% in patients with moderate crepitus, and from 50% to 38% in patients with mild symptoms. The percentage of patients without crepitation increased from 15% to 54% by final follow-up. Predebridement, 14% of patients had moderate pain, and 53% mild pain. By final follow-up, 38% had mild pain and 62% were pain free. Patients benefitted from debridement regardless of method of ACL reconstruction. Arthroscopic debridement did not increase anterior knee translation. Both groups gained extension and had improved activity levels with the passage of time from ACL surgery.
Cannon
W D
WD
Department of Orthopaedic Surgery, Davies Medical Center, San Francisco, University of California 94143-0728.
Vittori
J M
JM
D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy; D003646:Debridement / Q000379:methods*; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000503:physiopathology / Q000601:surgery*; D007719:Knee Joint / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000601:surgery*; D012189:Retrospective Studies