Quadrupled semitendinosus anterior cruciate ligament reconstruction: 5-year results in patients without meniscus loss

Purpose: The purpose of this study was to determine the mid-term (minimum 5 -year) results of isolated primary anterior cruciate ligament (ACL) reconst ructions with intact or repaired menisci. Type of Study: Case series. Metho ds: Of 184 ACL reconstructions from April 1990 to February 1992, 33 initial ly met the inclusion criteria of primary reconstruction with quadrupled sem itendinosus tendon and without extra-articular reconstruction or meniscus r emoval. Patients with known traumatic rerupture of the graft with revision (I case) or subsequent meniscectomy (1 case) were excluded from the study. Twenty of the remaining 31 patients were available for follow-up at an aver age of 5.7 years after surgery. At follow-up, a comprehensive knee examinat ion, KT-1000 arthrometry, radiography, functional testing, and isokinetic s trength testing were performed. A subjective questionnaire, Tegner scale, a nd IKDC evaluation were administered as well. Four patients who were unable to come in for follow-up returned a knee-assessment questionnaire. Results : Arthrometric anterior tibial translation was reduced from a preoperative average of 6.3 +/- 2.8 mm (manual maximum side-to-side difference) to an av erage of 0.0 +/- 1.3 mm (range, -2.5 to 2 mm). Radio graphic ally, I patien t experienced mild narrowing in the lateral compartment. Tegner activity le vel was maintained at the preinjury level in nearly half the patients. Isok inetic strength deficits were less than 10%; 17 (85%) of the patients had a normal or nearly normal result as graded by the IKDC scoring system. Concl usions: The above data show minimal morbidity, a low reoperation rate, and excellent clinical outcome. Because the stability of the knee persists beyo nd 5 years after ACL reconstruction, patients are able to maintain preinjur y activity levels without reinjury.