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ACL Reconstruction--Five Years Later

Posted on: 05/14/2001
The anterior cruciate ligament (ACL) is a major stabilizer of the knee joint. This key knee ligament is commonly torn during sports activities. One of the most common ways that doctors repair a torn ACL is by taking out the middle section of the patellar tendon below the knee cap. This new graft includes the strip of patellar tendon, along with attached plugs of bone on each end. The doctor implants the new graft into the knee, making sure to line it up just like the original ligament.

The patellar tendon graft is reported to be one of the strongest types of graft material available for ACL reconstruction. However, there have been questions about how well this method of reconstructing the ACL holds up over time.

These authors followed up on 32 patients who had arthroscopic surgery using the patellar tendon graft. The arthroscope was used to implant the new graft. The arthroscope is a tiny TV camera inserted through a small incision. It allows doctors to look inside a joint while reconstructing the knee.

The 32 patients were followed over five years after their ACL reconstruction using this procedure. The patients did physical tests and answered questions about their pain and activities both before their surgery and five years later. These physical tests compared the patients' operated knee with their other knee.

Roughly 87% of the knees were classified as having good surgical results based on knee stability testing. The survey comparisons showed that 78% of patients were now doing a higher level of activities than they did before their ACL reconstruction. And 40% of patients had gone back to activities from before their ACL injuries.

The authors report that these findings are similar to results from other procedures used to repair torn ACLs. They conclude that this type of graft implanted with the assistance of an arthroscope shows good long-term results in surgical treatment of ACL ruptures.

References:
Jig V. Patel, FRCS, et al. Central Third Bone-Patellar Tendon-Bone Anterior Cruciate Ligament Reconstruction: A 5-Year Follow-up. In Arthroscopy. January/February 2000. Vol. 16. No. 1. Pp. 67-70.

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