Medium-Term Course of Clinical Function and Progression of Osteoarthritis after Primary Reconstruction of Anterior Cruciate Ligament: 5- to 8-Year Results

Abstract

This retrospective study reveals medium-term postoperative results in anterior cruciate ligament reconstruction with a bone-tendon-bone autograft of the middle third of the patellar ligament, 5 to 8 years after surgery. A total of 44 patients with a mean age of 34.7 years was followed up for an average of 72.5 months.

Objective stability of the knee was evaluated by means of Lachman, pivot shift, anterior drawer and KT-1000 arthrometer measurements. 95.5% of the knees were stable, with a side-to-side difference < 3 mm. The evaluated knee score systems showed excellent results. Mean Lysholm score amounted to 95.5 points, and with the Tegner activity score, 81.8% of the patients regained their pre-injury activity level. Using IKDC grading, 88.6% of the knees were rated normal (A) or nearly normal (B), and asked for a personal assessment of their knee function, 93.2% of the patients rated it A or B, expressing a high grade of satisfaction with the result of surgery. The postoperative course of osteoarthritis showed a deterioration on the IKDC scale in 5 knees (11.4%), 2 with grade C signs of progressive osteoarthritis. A highly significant correlation (p < 0.01) was observed for progression of osteoarthritis and laxity of reconstruction >: 2 mm in the KT-1000 measurement.

Reconstruction of the anterior cruciate ligament using a bone-tendon-bone autograft of the patellar ligament leads to good medium-term results with minimal progression of osteoarthritis. Restoration of ligamentous stability of the knee is important in preventing or retarding the progression of osteoarthritis following anterior cruciate ligament injury.