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.
Key Words
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Article info
Footnotes
Supported by The Norra Älvsborgs and Bohus County Councils Development and Research Fund, and the Swedish National Centre for Research in Sports.
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© 2005 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
