Results of arthroscopic treatment of torn anterior cruciate ligament using patellar tendon autograft

ABSTRACT

The operative technique for ACL reconstruction has evolved from the traditional arthrotomy to the arthroscopic-assisted reconstruction and to the latest technique, which is the totally arthroscopic reconstruction. The aim of this work was to analyze the results of a totally arthroscopic ACL technique by patellar tendon autograft with an accelerated postoperative rehabilitation program. Between March 1997 and October 2000, a prospective study of 54 patients suffering from knee instability due to anterior cruciate injury was done in Assiut University Hospital. The patients were 53 males und one female with the age range of 18 years [average 30 years]. Four patients had a previous arthroscopic partial meniscectomy and three patients had a previous failed reconstruction of the ACL. The follow up continued until October 2000 with an average of 24 months period [range 9-42 months]. Out of the 54 patients included in the study, the results of 9 patients were deducted because they were lost to follow up. The overall results were satisfactory in 39 knees and unsatisfactory in 6 knees with 34 patients returned to their pre-injury level of activity. The Lysholm score improved from a preoperative mean of 59 to a postoperative mean of 91. Radiological assessment of tunnels placement revealed the tibial tunnel was 43.11 +/- 4.98%. The tibial tunnel position was found to be posterior in 27 patients, central in 12 patients and anterior in 6 patients. Tibia1 tunnel widening [0.5 - 2 mm] occurred in 7 patients, 3-6 months postoperatively. Arthroscopic ACL reconstruction with bone-patellar tendon-bone autograft with an accelerated postoperative rehabilitation program in young adults leads to reasonable stability and good overall function of the knee joint