title: Anterior cruciate ligament reconstruction with autogenous patellar tendon graft followed by accelerated rehabilitation. A two- to nine-year followup.
abstract: We sought to determine the long-term results of 1057 consecutive patients who underwent an anterior cruciate ligament reconstruction with an autogenous patellar tendon graft from 1987 through 1993 and who followed an accelerated rehabilitation program. The patients were followed prospectively and objective physical examination data were obtained on 806 patients at a mean of 4.0 years postoperatively. Subjective follow-up data were obtained on 948 patients at a mean of 4.4 years postoperatively. The mean final range of motion was 5 degree/0 degrees/140 degrees. The mean manual maximum KT-1000 arthrometer score was 2.0 +/- 1.5 mm. Isokinetic quadriceps muscle strength testing revealed a mean of 94% strength after acute reconstructions and 91% strength after chronic reconstructions. International Knee Documentation Committee evaluation after acute reconstruction rated 42% of knees as normal, 47% as near normal, 10% as abnormal, and 1% as severely abnormal. The same evaluation after chronic reconstruction rated 41% of knees as normal, 44% as near normal, 14% as abnormal, and 1% as severely abnormal. Radiographically, 94% of acute knees and 89% of chronic knees had no joint space narrowing. Subjective modified Noyes questionnaire results showed a mean score of 93.2 +/- 7.9 points. The mean time for patients to return to sport-specific activities was 6.2 weeks and to athletic competition at full capacity was 6.2 months postoperatively. In the long-term, patients exhibited full range of motion, excellent stability, good strength, and a return of full function in most cases.
authors.affiliation: Methodist Sports Medicine Center, Thomas A. Brady Clinic, Indianapolis, Indiana 46202, USA.
authors.forename: K D
authors.initials: KD
authors.lastname: Shelbourne
authors.forename: T
authors.initials: T
authors.lastname: Gray
mesh_terms: D000203:Activities of Daily Living; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D001696:Biomechanical Phenomena; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000150:complications / Q000534:rehabilitation* / Q000601:surgery*; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery; D008875:Middle Aged; D010329:Patella; D011183:Postoperative Complications; D011446:Prospective Studies; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures; D013710:Tendons / Q000637:transplantation*; D000070600:Tibial Meniscus Injuries