A comparison of results in acute and chronic anterior cruciate ligament ruptures of arthroscopically assisted autogenous patellar tendon reconstruction.
We conducted a prospective study of 94 consecutive patients who received a patellar tendon autograft for anterior cruciate ligament rupture. Eighty-seven patients (93%) returned for followup a mean of 28 months postoperatively; 57 had chronic and 30 had acute or subacute ruptures. There were no significant differences between the subgroups for age, sex, articular cartilage lesions, or months of followup. Forty-six meniscal tears were repaired; 27 of these extended into the central avascular region. Rehabilitation emphasized immediate knee motion, but strenuous activity was delayed for at least 4 months. Only one patient had a knee motion complication, and stability (<3 mm, KT-2000 arthrometer, 134 N) was restored in 85% of knees with chronic ruptures and 92% of knees with acute ruptures. Earlier reconstruction should be considered in active persons as symptoms and limitations continued postoperatively in knees with chronic ruptures, leading to overall less satisfactory results. In patient rating of the overall knee condition, 69% of knees with chronic ruptures and 100% of knees with acute ruptures scored in the normal or very good range. Repair of meniscal tears that extend into the central avascular region should be considered, as 24 of the 27 (89%) menisci repaired showed clinical evidence of healing and did not require reoperation.
Noyes
F R
FR
Cincinnati Sportsmedicine and Orthopaedic Center and the Deaconess Hospital, Ohio 45219, USA.
Barber-Westin
S D
SD
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy; D001265:Athletic Injuries / Q000534:rehabilitation; D002358:Cartilage, Articular / Q000293:injuries / Q000601:surgery; D002908:Chronic Disease; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery; D008875:Middle Aged; D017847:Patellar Ligament / Q000637:transplantation*; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012421:Rupture; D012737:Sex Factors; D000070600:Tibial Meniscus Injuries; D013997:Time Factors; D014182:Transplantation, Autologous; D014945:Wound Healing