Vascularized patella tendon anterior cruciate ligament reconstruction

E. A. Arendt, R. E. Hunter, W. T. Schneider

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

Forty-seven patients with a chronic anterior cruciate ligament (ACL) deficiency were treated with patella tendon ACL reconstructions from July 1980 to September 1983. All patients had a minimum two-year follow-up period (range, 24-54 months). Forty-two patients (89%) had meniscal damage in association with the ACL deficiency. This included seven menisci (17%) that had a stable tear and were left in place without suture fixation. Only five patients (11%) had normal menisci at the time of reconstruction. Functional and subjective results were obtained from a questionnaire that included a comprehensive evaluation of patients' symptoms and activities. Objective results were analyzed on the basis of a thorough physical examination, augmented with arthrometer instrumented drawer testing. The detailed questionnaire was returned by 42 patients (89%). Follow-up examinations were obtained for 37 patients (79%), with arthrometer testing of 35 patients (75%). A 100-point rating scale defined objective, subjective, and functional results. Stability testing, using Lachman's test, was judged to be ≤ 5 mm of anteroposterior tibiofemoral translocation in 51% of the patients examined and ≤ 10 mm of translation in 89%. Stability by arthrometer testing was ≤ 5 mm side-to-side difference in 83%. No patient lost a menisci after reconstruction. This included six patients with stable tears that were left unsutured. Subjective results were good or better in 60%. Functional results were good or better in 52%, with 41 of 42 patients participating in some form of recreational sports postoperatively. There was a large discrepancy between objective findings and the subjective and functional results (14% poor results compared with 31% and 43%, respectively). Although objective stability could be surgically restored in an ACL-deficient knee, the quality of the knee at the time of reconstruction as well as the postoperative and rehabilitative regimen are implicated in patients with poor subjective and functional results.

Original languageEnglish (US)
Pages (from-to)222-232
Number of pages11
JournalClinical orthopaedics and related research
Issue number244
DOIs
StatePublished - 1989

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