Abstract
We sought to determine the effect, if any, the presence of an untreated articular cartilage defect observed during ACL reconstruction would have on the results following surgery.
From 1987 to 1997, 34 of 2264 ACL reconstructions were found to have an isolated articular cartilage defect of the femoral condyles that were Fairbanks grade 3 or 4. This study group (DEF group) comprised 28 men and 6 women with a mean age of 28. 3 + 10. 1 years. These patients were matched for sex, age at time of surgery, injury type and sport played at time of injury from our prospective ACL database. None of the control group (CONT group) had any associated meniscus or chondral damage and had a mean age of 27. 3 + 8. 8 years. Routine subjective, objective and radiological prospective follow-up was undertaken.
The mean subjective follow up was 7. 2 + 3. 3 years and 7. 1 + 2. 9 in the DEF and CONT groups respectively with objective follow up similarly being 5. 4 + 3. 3 years and 5. 4 + 2. 5 years respectively. The annual mean subjective scores for the two groups were the same (all above 90) each year after surgery up to 12 years. 96% in the DEF group and 100% of patients in the CONT group returned to their same sports. The IKDC radiographic rating had 31 patients in the DEF group and 32 in the CONT group with normal or nearly normal knees.
Radiographic arthritic progression was seen in 6 patients in each group. Stability, range of motion and strength were similar in the two groups during follow-up. We found no significant difference between the two groups in any variable studied.
This study show that patients with chondral defects do not differ subjectively, objectively or radiographically from a matched control group for up to 12 years after surgery.
The abstracts were prepared by Mr Simon Donell. Correspondence should be addressed to him at the Department of Orthopaedics, Norfolk & Norwich Hospital, Level 4, Centre Block, Colney Lane, Norwich NR4 7UY, United Kingdom
