Complications and Prognostic Factors of Endoscopic Anterior Cruciate Ligament Reconstruction Using Autogenous Patellar Tendon / 대한정형외과학회잡지

ABSTRACT

PURPOSE: The purpose of this study is to evaluate the author's cases of arthroscopic one-tunnel anterior cruciate ligament reconstruction using autogenous patellar tendon in which the complications occured as well as offer advice on how to avoid them and salvage the situation if they occur. MATERIAL AND METHODS: Ninety cases out of 164 arthroscopic ACL reconstructions were followed up for more than 12 months (average 27 months) . The clinical results were evaluated by OAK and IKDC knee rating systems and radiographic results by lateral roentgenographs of the fully extended knee. Fifty-two cases were evaluated by a second look arthroscopy at least 12 months postoperatively. RESULTS: Poor results were noted only in 5 (5%) cases. Four cases out of the 5 poor results were chronic ACL deficient knees, and 2 cases out of the 5 had valgus instability. Mean percentage of roof impingement was -5.7%. Impingement was noted in 11 cases and 3 cases out of the 11 had poor results. During second look arthroscopy, grafted ACL of nearly normal appearance were noted in 26 (50%) cases. Five cases showed impingement and 3 cases out of the 5 had poor results. CONCLUSION: The results of our study denote that chronicity of ACL injury is a prognostic factor for the result after reconstruction, and more so for combined ACL and medial collateral ligament injury. Also, verifying accurate placement of tunnels for graft by arthroscope or intraoperative radiograph seems to be an essential step in preventing impingement, which was shown to be an important prognostic factor according to the results of this study.