A COMPARISON OF RESULTS IN ACUTE AND CHRONIC ANTERIOR CRUCIATE LIGAMENT RUPTURES OF ARTHROSCOPICALLY ASSISTED AUTOGENOUS PATELLAR TENDON RECONSTRUCTION
Fr. Noyes et Sd. Barberwestin, A COMPARISON OF RESULTS IN ACUTE AND CHRONIC ANTERIOR CRUCIATE LIGAMENT RUPTURES OF ARTHROSCOPICALLY ASSISTED AUTOGENOUS PATELLAR TENDON RECONSTRUCTION, American journal of sports medicine, 25(4), 1997, pp. 460-471
We conducted a prospective study of 94 consecutive patients who receiv
ed a patellar tendon autograft for anterior cruciate ligament rupture.
Eighty-seven patients (93%) returned for followup a mean of 28 months
postoperatively; 57 had chronic and 30 had acute or subacute ruptures
, There were no significant differences between the subgroups for age,
sex, articular cartilage lesions, or months of followup. Forty-six me
niscal tears were repaired; 27 of these extended into the central avas
cular region. Rehabilitation emphasized immediate knee motion, but str
enuous activity was delayed for at least 4 months. Only one patient ha
d a knee motion complication, and stability (3 mm, KT-2000 arthrometer
, 134 N) was restored in 85% of knees with chronic ruptures and 92% of
knees with acute ruptures. Earlier reconstruction should be considere
d in active persons as symptoms and limitations continued postoperativ
ely in knees with chronic ruptures, leading to overall less satisfacto
ry results. In patient rating of the overall knee condition, 69% of kn
ees with chronic ruptures and 100% of knees with acute ruptures scored
in the normal or very good range. Repair of meniscal tears that exten
d into the central avascular region should be considered, as 24 of the
27 (89%) menisci repaired showed clinical evidence of healing and did
not require reoperation.