[Seventeen year outcome after anterior cruciate ligament reconstruction with a intact or repaired medial meniscus].
OBJECTIVE
Ten-year outcome of anterior cruciate ligament (ACL) reconstruction was previously reported (1992-1993) for 148 patients who had ACL free grafts associated with extra-articular tenodesis. In this retrospective study, we examined the functional and radiological changes observed 17 years after surgery in patients whose menisci were intact or repaired at ACL reconstruction (46 cases). These patients were operated on between 1978 and 1983.


METHODS
Between January and April 1999, 28 patients were reviewed clinically and radiographically. Nine other patients responded to a questionnaire and three of them sent their x-rays. Two patients had died since the last review and 7 were lost to follow-up. Mean age at follow-up was 41 years. The IKDC classification was A 18.5%, B 51%, C 22.2%, D 7.4% in 26 patients reviewed with the passive radiological Lachman. At subjective analysis (n=37), 70% of the patients were very satisfied and 27% were satisfied. At radiological analysis (n=31), the AP or lateral single-limb stance views and the AP two-limb weight bearing views at 45% flexion demonstrated preosteoarthritis in 22% and osteoarthritis in 3%. Residual anterior tibial translation was the same at 11 years and 17 years follow-up.


CONCLUSIONS
This study clearly demonstrates that ACL reconstruction associated with extra-articular tenodesis can provide good functional and radiological results at 17 years mean follow-up for patients with preserved (sound or sutured) menisci. The status of the medial meniscus at long-term follow-up appears to be the key feature determining the low rate of degenerative changes.
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Service d'Orthopédie et Traumatologie, CHU d'Angers, 4, rue Larrey, 49000 Angers.
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D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008592:Menisci, Tibial / Q000601:surgery*; D008875:Middle Aged; D012189:Retrospective Studies; D013537:Sutures; D013997:Time Factors