Outcome and risk factors after anterior cruciate ligament reconstruction: a follow-up study of 948 patients.
OBJECTIVE
The aim of the study was to assess the outcome and risk factors after anterior cruciate ligament (ACL) reconstruction in a large group of patients.


METHODS
Case series.


METHODS
Included in this retrospective study were 948 patients (323 female, 625 male) with a symptomatic unilateral ACL rupture, who underwent arthroscopic reconstruction using patellar tendon autograft and interference screw fixation at 3 Swedish hospitals. The median age of the patients at the time of the index operation was 26 years (range, 14 to 53 years). The patients underwent surgery at a median of 12 months (range, 0.5 to 360 months) after their injury. Independent physiotherapists performed the follow-up examinations at a median of 32 months (range, 21 to 117 months) postoperatively.


RESULTS
Of the 948 patients, 550 (58%) underwent meniscal surgery before, during, or after the ACL reconstruction. The median Tegner activity level was 8 (range, 2-10) before injury, 3 (range, 0-9) preoperatively, and 6 (range, 1-10) at follow-up (P < .0001 preoperative v follow-up). At follow-up, the median Lysholm score was 90 points (range, 14-100), the median KT-1000 anterior side-to-side laxity difference was 1.5 mm (range, -6 to 13 mm), and the median 1-leg hop test quotient was 95% (0% to 167%) compared with the contralateral normal side. At follow-up, 69.3% of the patients were classified as normal or nearly normal according to the International Knee Documentation Committee evaluation system. However, 36% of the patients were unable to or had severe problems performing the knee-walking test. Inferior results correlated with increased time period between the index injury and reconstruction and concomitant joint damage found at the index operation.


CONCLUSIONS
Overall, the results were good after ACL reconstruction using patellar tendon autograft and interference screw fixation. Concomitant joint damage and a long time period between the injury and reconstruction are major risk factors for inferior outcome after ACL reconstruction.


METHODS
Level IV, case series.
Laxdal
Gauti
G
Department of Orthopaedics, Sahlgrenska University Hospital , Göteborg, Sweden.
Kartus
Jüri
J
Ejerhed
Lars
L
Sernert
Ninni
N
Magnusson
Lennart
L
Faxén
Eva
E
Karlsson
Jon
J
D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D001182:Arthroscopy; D001863:Bone Screws; D015331:Cohort Studies; D005260:Female; D005264:Femoral Fractures / Q000453:epidemiology / Q000601:surgery; D005269:Femur / Q000601:surgery / Q000637:transplantation*; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017847:Patellar Ligament / Q000293:injuries / Q000637:transplantation*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D012421:Rupture / Q000453:epidemiology / Q000601:surgery; D012720:Severity of Illness Index; D013710:Tendons / Q000601:surgery / Q000637:transplantation*; D013977:Tibia / Q000601:surgery / Q000637:transplantation*; D013978:Tibial Fractures / Q000453:epidemiology / Q000601:surgery; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome