title: Arthroscopic reconstruction of the anterior cruciate ligament with patellar-tendon autograft and interference screw fixation. The results at seven years.
abstract: Deficiency of the anterior cruciate ligament (ACL) is a common disorder which can lead to changes in lifestyle. We followed 59 patients who had had arthroscopic reconstruction of the ACL using a central-third patellar-tendon autograft for seven years to assess the long-term effectiveness of recent advances in reconstruction of the ACL. The standard criteria for evaluation of the International Knee Documentation Committee, the Lysholm knee score and measurements using the KT 1000 arthrometer all showed satisfactory results. Deterioration in the clinical performance after seven years was associated with osteoarthritic changes and correlated with chronic ligament injuries and meniscectomy. There were three traumatic and three spontaneous ruptures. We believe that the procedure can be successful, but remain concerned about failure of the graft and osteoarthritis. The results raise questions about the best time to operate and suggest that early surgery may reduce the risk of osteoarthritis.
authors.affiliation: Australian Institute of Musculo-Skeletal Research, Sydney.
authors.forename: N M
authors.initials: NM
authors.lastname: Jomha
authors.forename: L A
authors.initials: LA
authors.lastname: Pinczewski
authors.forename: A
authors.initials: A
authors.lastname: Clingeleffer
authors.forename: D D
authors.initials: DD
authors.lastname: Otto
mesh_terms: D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000503:physiopathology / Q000637:transplantation*; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy / Q000379:methods*; D001863:Bone Screws; D001915:Braces; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007593:Joint Instability / Q000150:complications* / Q000628:therapy; D007718:Knee Injuries / Q000628:therapy*; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008592:Menisci, Tibial / Q000000981:diagnostic imaging; D008875:Middle Aged; D010329:Patella / Q000601:surgery*; D011859:Radiography; D016059:Range of Motion, Articular; D012008:Recurrence; D012086:Reoperation; D012421:Rupture / Q000628:therapy; D012422:Rupture, Spontaneous / Q000209:etiology / Q000628:therapy; D013710:Tendons / Q000637:transplantation; D000070600:Tibial Meniscus Injuries; D014182:Transplantation, Autologous; D016896:Treatment Outcome