title: Arthroscopic BPTB graft reconstruction in ACL ruptures: 15-year results and survival.
abstract: OBJECTIVE
  The aim of this study is to investigate the 15-year results and survival of arthroscopic ACL reconstruction using the central-third patellar bone-tendon-bone (BPTB) autograft.
  
  
  METHODS
  ACL BPTB reconstruction was performed in 250 consecutive patients. Of these patients, 88% returned for a follow-up examination at 15 years after reconstruction. Therefore, 220 patients were studied. Mean time from injury to intervention was 3.4months (range 2 to 16). The parameters for assessment of results were subjective satisfaction, clinical examination (pivot-shift test, Lachman test with KT-1000), recovery of pre-injury activity level, and long-leg standing radiographs. We also evaluated the presence of meniscal and/or chondral injuries during the procedure. Failure rates were also evaluated. We defined a failure as severe instability not compatible with the activities of daily living (ADL) due to graft rupture.
  
  
  RESULTS
  8.2% of patients required a revision procedure because of graft rupture. In subjective terms, 98.1% of patients said that they were satisfied with the surgical outcomes after 15 years. Pivot shift test was normal in 93.5% at 15 years. Lachman test (KT-1000) was normal in 95.4% at 15 years. Fifteen years after surgery, 90% of patients recovered their pre-injury activity level. In 25.4% of patients symptomatic osteoarthritic changes in the knee were found at 15 years.
  
  
  CONCLUSIONS
  The survival prevalence of arthroscopic ACL reconstruction using the central-third patellar bone-tendon-bone (BPTB) autograft at 15 years was 94.8%. Fifteen years after surgery, 90% of patients recovered their pre-injury activity level. In 25.4% of patients symptomatic osteoarthritic changes in the knee were found at 15 years.
  
  
  METHODS
  Level IV.
authors.affiliation: Knee Division, Department of Orthopaedic Surgery, La Paz University Hospital, Madrid, Spain. Electronic address: ecrmerchan@gmx.es.
authors.forename: E Carlos
authors.initials: EC
authors.lastname: Rodríguez-Merchán
authors.affiliation: Knee Division, Department of Orthopaedic Surgery, La Paz University Hospital, Madrid, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Durán
authors.affiliation: Knee Division, Department of Orthopaedic Surgery, La Paz University Hospital, Madrid, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Revilla
authors.affiliation: Knee Division, Department of Orthopaedic Surgery, La Paz University Hospital, Madrid, Spain.
authors.forename: Primitivo
authors.initials: P
authors.lastname: Gómez-Cardero
authors.affiliation: Knee Division, Department of Orthopaedic Surgery, La Paz University Hospital, Madrid, Spain.
authors.forename: Angel
authors.initials: A
authors.lastname: Martínez-Lloreda
authors.affiliation: Knee Division, Department of Orthopaedic Surgery, La Paz University Hospital, Madrid, Spain.
authors.forename: Santiago
authors.initials: S
authors.lastname: Bello
mesh_terms: D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy; D050376:Bone-Patellar Tendon-Bone Grafting; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007718:Knee Injuries / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012421:Rupture / Q000601:surgery; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult
keywords: 15-year results; 15-year survival; ACL rupture; BPTB autograft; Reconstruction