Document Detail


Outcome and risk factors after anterior cruciate ligament reconstruction: a follow-up study of 948 patients.
MedLine Citation:
PMID:  16084293     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The aim of the study was to assess the outcome and risk factors after anterior cruciate ligament (ACL) reconstruction in a large group of patients. TYPE OF STUDY: Case series. METHODS: Included in this retrospective study were 948 patients (323 female, 625 male) with a symptomatic unilateral ACL rupture, who underwent arthroscopic reconstruction using patellar tendon autograft and interference screw fixation at 3 Swedish hospitals. The median age of the patients at the time of the index operation was 26 years (range, 14 to 53 years). The patients underwent surgery at a median of 12 months (range, 0.5 to 360 months) after their injury. Independent physiotherapists performed the follow-up examinations at a median of 32 months (range, 21 to 117 months) postoperatively. RESULTS: Of the 948 patients, 550 (58%) underwent meniscal surgery before, during, or after the ACL reconstruction. The median Tegner activity level was 8 (range, 2-10) before injury, 3 (range, 0-9) preoperatively, and 6 (range, 1-10) at follow-up (P < .0001 preoperative v follow-up). At follow-up, the median Lysholm score was 90 points (range, 14-100), the median KT-1000 anterior side-to-side laxity difference was 1.5 mm (range, -6 to 13 mm), and the median 1-leg hop test quotient was 95% (0% to 167%) compared with the contralateral normal side. At follow-up, 69.3% of the patients were classified as normal or nearly normal according to the International Knee Documentation Committee evaluation system. However, 36% of the patients were unable to or had severe problems performing the knee-walking test. Inferior results correlated with increased time period between the index injury and reconstruction and concomitant joint damage found at the index operation. CONCLUSIONS: Overall, the results were good after ACL reconstruction using patellar tendon autograft and interference screw fixation. Concomitant joint damage and a long time period between the injury and reconstruction are major risk factors for inferior outcome after ACL reconstruction. LEVEL OF EVIDENCE: Level IV, case series.
Authors:
Gauti Laxdal; Jüri Kartus; Lars Ejerhed; Ninni Sernert; Lennart Magnusson; Eva Faxén; Jon Karlsson
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association     Volume:  21     ISSN:  1526-3231     ISO Abbreviation:  Arthroscopy     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-08-08     Completed Date:  2006-03-20     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8506498     Medline TA:  Arthroscopy     Country:  United States    
Other Details:
Languages:  eng     Pagination:  958-64     Citation Subset:  IM    
Affiliation:
Department of Orthopaedics, Sahlgrenska University Hospital , Göteborg, Sweden.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anterior Cruciate Ligament / surgery*
Arthroscopy*
Bone Screws
Cohort Studies
Female
Femoral Fractures / epidemiology,  surgery
Femur / surgery,  transplantation*
Follow-Up Studies
Humans
Knee Injuries / epidemiology
Male
Middle Aged
Patellar Ligament / injuries,  transplantation*
Recurrence
Retrospective Studies
Risk Factors
Rupture / epidemiology,  surgery
Severity of Illness Index
Tendons / surgery,  transplantation*
Tibia / surgery,  transplantation*
Tibial Fractures / epidemiology,  surgery
Time Factors
Transplantation, Autologous
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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