ENDOSCOPIC RECONSTRUCTION FOR ISOLATED ANTERIOR CRUCIATE LIGAMENT RUPTURE

We treated 90 patients with an isolated injury to the anterior cruciat e ligament (ACL) by reconstruction using a patellar tendon autograft a nd interference screw fixation. Of these, 82 (91%) were available for review at 24 months. Two grafts and two contralateral ACLs had rupture d during sport and there was one case of atraumatic graft resorption. Using the asessment of the International Knee Documentation Committee (IKDC), 86% of the remaining patients were normal or nearly normal. Th e median Lysholm knee score was 95/100 and 84% of patients were partic ipating in moderate to strenuous activity. All had grade-0 or grade-1 Lachman, pivot-shift and anterior-drawer tests. Measurement with the K T1000 arthrometer gave a side-to-side difference of <3 mm of anterior tibial displacement in 90%. Sixty-six radiographs were IKDC grade A an d one was grade B. Pain on kneeling was present in 31% and graft site pain in 44%. At 24 months after operation all patients had excellent k nee stability, a high rate of return to sport and minimal radiological evidence of degenerative change. Our series therefore represents a ba sis for comparison of results using other techniques and after more se vere injuries.