Arthroscopic evaluation of anterior cruciate ligament reconstruction using a free patellar tendon autograft. A prospective, randomized study.
In a prospective study, follow-up arthroscopy was performed (with the informed consent of the patient) after anterior cruciate ligament reconstruction using a free patellar tendon autograft. Nineteen of 21 consecutive patients agreed to arthroscopy. Time between operation and arthroscopy ranged from six to 25 months (average, 15 months) and was distributed at random among the patients. In evaluating knee stability and functional performance, the arthroscopic findings were disappointing. The Lysholm score improved from 68 +/- 8 points preoperatively to 84 +/- 8 points postoperatively. KT-1000 measurement on the day before follow-up arthroscopy showed only a slightly increased anterior laxity of 6.2 mm compared to 4.7 mm on the uninjured side. When the arthroscopic results were graded from 0 (ruptured) to 3 (excellent), four patients had a Grade 3 result, ten patients had a Grade 2 (moderate) result, and five patients had a Grade 1 (poor) result. No graft was ruptured. These findings indicate that, in the majority of patients, reconstruction of the anterior cruciate ligament using a free patellar tendon autograft will not result in an arthroscopically normal substitute for the anterior cruciate ligament.
Kohn
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Orthopaedic Department, Hannover Medical School, Federal Republic of Germany.
D000328:Adult; D001182:Arthroscopy; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology; D007719:Knee Joint / Q000503:physiopathology; D008023:Ligaments, Articular / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D009068:Movement; D010329:Patella; D011446:Prospective Studies; D011897:Random Allocation; D013710:Tendons / Q000473:pathology / Q000637:transplantation*