The Outcome at 15 Years of Endoscopic Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon Autograft for 'Isolated' Anterior Cruciate Ligament Rupture

J Bone Joint Surg Br. 2012 May;94(5):630-7. doi: 10.1302/0301-620X.94B5.28675.

Abstract

The purpose of this study was to report the outcome of 'isolated' anterior cruciate ligament (ACL) ruptures treated with anatomical endoscopic reconstruction using hamstring tendon autograft at a mean of 15 years (14.25 to 16.9). A total of 100 consecutive men and 100 consecutive women with 'isolated' ACL rupture underwent four-strand hamstring tendon reconstruction with anteromedial portal femoral tunnel drilling and interference screw fixation by a single surgeon. Details were recorded pre-operatively and at one, two, seven and 15 years post-operatively. Outcomes included clinical examination, subjective and objective scoring systems, and radiological assessment. At 15 years only eight of 118 patients (7%) had moderate or severe osteo-arthritic changes (International Knee Documentation Committee Grades C and D), and 79 of 152 patients (52%) still performed very strenuous activities. Overall graft survival at 15 years was 83% (1.1% failure per year). Patients aged < 18 years at the time of surgery and patients with > 2 mm of laxity at one year had a threefold increase in the risk of suffering a rupture of the graft (p = 0.002 and p = 0.001, respectively). There was no increase in laxity of the graft over time. ACL reconstructive surgery in patients with an 'isolated' rupture using this technique shows good results 15 years post-operatively with respect to ligamentous stability, objective and subjective outcomes, and does not appear to cause osteoarthritis.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Anterior Cruciate Ligament / surgery
  • Anterior Cruciate Ligament Injuries*
  • Anterior Cruciate Ligament Reconstruction / methods*
  • Arthrometry, Articular / methods
  • Endoscopy / methods
  • Female
  • Follow-Up Studies
  • Graft Survival
  • Humans
  • Knee Joint / diagnostic imaging
  • Knee Joint / physiopathology
  • Male
  • Middle Aged
  • Osteoarthritis, Knee / etiology
  • Osteoarthritis, Knee / prevention & control
  • Radiography
  • Rupture / surgery
  • Tendons / transplantation*
  • Treatment Outcome
  • Weight-Bearing / physiology
  • Young Adult