Arthroscopic-assisted anterior cruciate ligament reconstruction with autogenous patellar tendon graft. A 5-year follow-up

This study presents the five-year follow-up-results (range 56 to 63 months) of 76 of 119 patients who had had arthroscopically assisted reconstruction of the anterior cruciate ligament with use of the central third patellar t endon for acute rupture (19 patients = group A) or chronic ACI insufficienc y (57 patients = group B) between may 1991 and october 1993 in the Departme nt of Trauma Surgery University Hospital Ulm. The average Lysholm knee scor e was 94.6 points (group A = 97.1,group B = 93.8 points). The IKDC-score ra ted 21.10% of all patients as A (group A = 31.6%, group B = 17.5%), 57.9% a s B (group a = 52.6%, group B = 59.6%), 19.7% as C (group A = 15.8%, group B 21.7%) and one patient of group B as level D. 9 patients (= 11.8%, group A = 21.1%, group B = 8.8%) showed up to 10 degre e extension loss (compared with contralateral kneel, one patient of group A (1.3%) more than 10 degree. A flexion loss up to 15 degree was seen in 12 patients (= 15.8%, group A = 21.1%, group B = 14.0%), of more than 15 degre e in 3 patients (= 3.9%, group A = 5.3%, group B = 3.5%).The average KT-100 0-side-to-side difference was 2.5 mm with 90 N (group A 2.4 mm,group B = 2. 5 mm), 2.8 mm with 133 N (group A = 2.7 mm, group B = 2.8 mm) and 3.2 mm (b oth groups) for manual maximum. There was no statistically significant diff erence in quadriceps and hamstring isokinetic strength (Cybex) of operated vs. unaffected limb for 60 /s as well as 240 /s. X-ray analysis showed arth rotic signs of minimum one compartment in 22.3% of all patients (group A = 26.3%, group B = 21.1%). In summary, we found better long-term results of IKDC-score in patients wit h autogenous patellar tendon graft for acute ACL-rupture vs. chronic ACL in sufficiency. In Lysholm knee score and KT-1000 arthrometric measurement we just saw little but not statistically significant differences between the t wo groups. The isokinetic strength of quadriceps and hamstring were similar between op erated vs. unaffected limb as well as between group A and B.