Long term osteoarthritic changes in anterior cruciate ligament reconstructed knees

To consolidate the indications for anterior cruciate ligament reconstructio n and clarify the long term prognosis associated with current surgical and rehabilitation techniques, the incidence of osteoarthritis in arthroscopica lly anterior cruciate ligament reconstructed knees requires investigation. Seventy-two patients with anterior cruciate ligament ruptures who were acti ve in sports requiring sidestepping and pivoting, or who had recurrent epis odes of giving way, underwent arthroscopic bone-patellar tendon-bone anteri or cruciate ligament reconstruction, These patients were evaluated for meni scal damage and osteoarthritic changes at the time of surgery and followed up for 7 years. Fifty-three patients underwent radiographic evaluation at 7 years, which included anteroposterior, lateral, skyline,, and 30 degrees p osteroanterior weightbearing views, Radiographic evaluation was performed b y three independent surgeons and graded as per International Knee Documenta tion Committee criteria. Results revealed that knees with chronic anterior cruciate ligament deficiency, even those with intact menisci before reconst ruction, suffered early osteoarthritic changes. More severe changes were se en with meniscectomy, Acute anterior cruciate ligament reconstruction with meniscal preservation was shown to have the lowest incidence of degenerativ e change. Controversy exists regarding the timing of anterior cruciate liga ment reconstruction. This study supports early reconstruction of anterior c ruciate ligament deficient knees before episodes of giving way occur in ind ividuals intent on continuing activities that involve sidestepping and pivo ting.