title: Long-term results after reconstruction of the ACL with hamstrings autograft and transtibial femoral drilling.
abstract: OBJECTIVE
  To evaluate the long-term clinical, patient-reported and radiological outcome of patients reconstructed for anterior cruciate ligament (ACL) insufficiency. We wanted to examine the relationship between clinical findings and patient-reported scores.
  
  
  METHODS
  The 96 first successive patients that underwent ACL reconstruction using transtibial technique, hamstrings autograft and tunnel placement ad modum Howell were evaluated 10 years post-operatively. Subjective outcomes were Lysholm score, IKDC 2000 subjective score and Tegner activity scale. The clinical examination included evaluation of rotational and sagittal laxity. Evaluation of osteoarthritis was done radiologically.
  
  
  RESULTS
  Eighty-three patients (86%) were available for follow-up at mean 10.2 years post-operatively. Three patients had revision ACL surgery prior to the 10-year evaluation. The mean Lysholm score, subjective IKDC 2000 score and Tegner activity scale were 89 (SD 13), 83 (SD 15) and 5 (range, 3-9), respectively. Six patients (8%) had moderate or severe osteoarthritis. Eighty-six per cent of patients had normal or near-normal anterior-posterior ACL laxity. Twenty per cent of patients had positive pivot shift and 42 % had a pivot glide. The former group had a significant lower Lysholm score compared to the rest of the patients.
  
  
  CONCLUSIONS
  Although the mean Lysholm score was classified as good (89) at the 10-year follow-up, a positive pivot shift was found in 20% of these patients. Compared to patients with normal rotational laxity or pivot glide, this patient group reported significant lower subjective satisfaction at the long-term follow-up.
  
  
  METHODS
  Case series, level IV.
authors.affiliation: Surgical Department, Haraldsplass Deaconess Hospital, Pb 6165, 5152, Bergen, Norway. eivind.inderhaug@gmail.com
authors.forename: Eivind
authors.initials: E
authors.lastname: Inderhaug
authors.forename: Torbjørn
authors.initials: T
authors.lastname: Strand
authors.forename: Cornelia
authors.initials: C
authors.lastname: Fischer-Bredenbeck
authors.forename: Eirik
authors.initials: E
authors.lastname: Solheim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D064592:Autografts; D005260:Female; D005269:Femur / Q000601:surgery; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D013710:Tendons / Q000637:transplantation*; D016896:Treatment Outcome; D055815:Young Adult