INTRAARTICULAR ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION IN THE SYMPTOMATIC ARTHRITIC KNEE

We reviewed a consecutive series of young symptomatic patients with ch ronic anterior cruciate ligament-deficient knees to determine if an au togenous patellar tendon graft reconstruction decreased their symptoms and increased the stability of the knee. All patients had radiographi c evidence of posttraumatic arthritis. Thirty-three patients met our c riteria for inclusion in the study. Time from injury to reconstruction of the anterior cruciate ligament averaged 105 months. All patients u nderwent an accelerated rehabilitation program designed to help them r egain full range of motion as soon as possible. Preoperative and posto perative range of motion, strength, stability, and subjective evaluati ons were compared. Followup averaged 44.8 months. Follow-up range of m otion was not significantly different from preoperative measurements ( P = 0.51). Postoperative stability, as measured by KT-1000 arthrometer maximum manual test, averaged 2.7 mm versus 8.4 mm preoperatively (P < 0.001). Isokinetic testing revealed no difference in the quadriceps strength after reconstruction (P = 0.99). Patients' subjective scores on a modified Noyes questionnaire improved for pain, stability, and ac tivity level, with a total improvement from 55 to 81 points. Although the procedure and rehabilitation were successful in providing stabilit y and decreasing pain, patients were still encouraged to limit high-im pact athletic and occupational activity.