Abstract
We report on a minimum 5-year follow-up (mean 7 years) of 28 patients who underwent arthroscopically assisted ACL reconstruction using a patellar tendon graft. Knee function was assessed using Lysholm and Tegner scores and AP translation of the tibia was measured using a Stryker Laxity Tester, comparing the symptomatic with the normal knee. All measurements were made preoperatively and at the latest follow-up. In addition, all patients had standardised weight-bearing radiographs of the knee to assess joint space narrowing using the IKDC radiographic grading.
The mean preoperative Lysholm score of 71 (range 46–95) improved to 88 (range 57–100) at follow-up. The mean Tegner Activity score increased from 4.1 (range 1–6) to 7.2 (range 5–10). Preoperatively 17 patients had increased tibial translation of more than 5mm, 9 had 3–5mm and 2 had less than 3mm. At follow-up, 22 knees had less than 3mm tibial translation and 6 had 3–5mm. No patients had more than 5mm of tibial translation compared to the opposite knee. The IKDC radiographic grading of joint space narrowing revealed 14 patients with no narrowing, 11 with a joint space of more than 4mm and knees with a joint space of 2–4mm. Joint space narrowing was seen in patients who had partial or total meniscectomy before or at the time of ACL reconstruction.
These results indicate that the satisfactory outcome of ACL reconstruction using contemporary methods is maintained beyond 5 years. However, the 50% incidence of joint space narrowing associated with previous meniscectomy is a cause for concern.
The abstracts were prepared by Mr R. B. Smith. Correspondence should be addressed to him at the British Orthopaedic Association, Royal College of Surgeons, 35-43 Lincoln’s Inn Fields, London WC2A 3PN.
