THE EFFECT OF INJURY CHRONICITY AND PROGRESSIVE REHABILITATION ON SINGLE-INCISION ARTHROSCOPIC ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

We conducted a prospective study on 50 consecutive patients who receiv ed a single-incision arthroscopic patellar tendon autograft reconstruc tion for anterior cruciate ligament (ACL) rupture. The purposes were t o determine if differences existed in results between patients with ac ute and chronic ACL ruptures, and if a progressive rehabilitation prog ram could safely return patients to sports activities early without co mpromising knee stability. Forty-two patients (84%) returned for follo w-up a mean of 31 months postoperatively. Twenty-one patients had acut e ruptures, and 21, chronic ruptures. A progressive rehabilitation pro gram was used by 28 patients (67%) who met strict criteria, which allo wed early return to running and sports activities. The results were ra ted with the Cincinnati Knee Rating System. We found no effect of eith er injury chronicity or time to return to activity for 21 factors, inc luding anterior-posterior displacement, patellofemoral crepitus, range of knee motion, quadriceps muscle strength, symptoms, functional limi tations, or the patient rating of outcome. Using arthrometer and pivot -shift test data, 30 knees (71%) had a functional reconstruction; 8 kn ees (19%) had partial function; and 4 knees (10%) failed. Patients exp ressed satisfaction with the operation as follows: 23 (55%) rated thei r overall knee condition as normal; 16 (38%), very good; and 3 (7%), g ood. No patients rated their knee condition as fair or poor.