Arthroscopically assisted anterior cruciate ligament reconstruction using patellar tendon autograft. Five- to nine-year follow-up evaluation. The American journal of sports medicine 26

ABSTRACT We retrospectively reviewed the results of 97 patients with anterior cruciate ligament reconstructions using an arthroscopically assisted two-incision technique without extraarticular augmentation at an intermediate followup of 5 to 9 years postoperatively. Evaluation included detailed history, physical examination, functional testing, KT-1000 arthrometer measurements, multiple scoring systems, and radiographs. The results were compared with those from a previous study that evaluated a smaller patient cohort using the identical surgical technique at a 2-to 4-year followup. The postoperative physical examination and KT-1000 arthrometer results were statistically improved when compared with preoperative findings. A negative pivot shift result was noted in 83% of patients, and a 1ϩ result in 17% of patients. Seventy percent of patients had Ͻ3 mm difference on manual maximum side-to-side testing. Functional testing averaged less than 2% asymmetry for vertical jump, single-legged hop, or timed 6-meter hop. The Tegner activity level was significantly improved from prereconstruction ratings and similar to preinjury ratings. The mean Lysholm score was 87. The modified Hospital for Special Surgery scores resulted in good or excellent results in 82% of the patients (mean, 87 points). The mean Noyes sports function score was 89, and the reoperation rate for a symptomatic knee flexion contracture was 12%. Ninety-seven percent of patients indicated that they would undergo the procedure again. When compared with this same population at 2 to 4 years, we saw no deterioration in scoring scale results. During the past decade arthroscopically assisted techniques have become accepted methods of reconstructing the ACL. 5-7, 13, 14, 19, 23, 24, 27, 31, 36, 45, 46 Despite many ACLrelated articles in the literature, there are few intermediate-or long-term studies evaluating the results of current, commonly performed techniques. The goals for this minimum 5-year follow-up study were to 1) evaluate clinical stability after this technique, 2) assess function, 3) evaluate patient satisfaction, and 4) compare our results at 5 to 9 years with those from an earlier study of 2 to 4 years' followup of this same surgical technique. 7 MATERIALS AND METHODS Patients who underwent two-incision arthroscopically assisted ACL reconstructions using patellar tendon autograft substitution without extraarticular augmentation between June 1987 and January 1991 were retrospectively reviewed. Patients were identified from a computerized data base maintained by the senior author (BRB), who performed all the surgical procedures. During this period, a variety of 189 knee ligament procedures were performed. Exclusionary criteria included concomitant ex