Jj. Larkin et Sd. Barberwestin, THE EFFECT OF INJURY CHRONICITY AND PROGRESSIVE REHABILITATION ON SINGLE-INCISION ARTHROSCOPIC ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION, Arthroscopy, 14(1), 1998, pp. 15-22
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.