Retrospective evaluation of the minimal invasive, “Healing response“ procedure in the treatment of a ACL-rupture in relatively young patients.
We treated 22 patients with a mean age of 32,5 years (16-45 years) after a proximal ACL-rupture arthroscopically with a rigorous standardized aftercare in a plaster cast and with physiotherapy. The mean follow-up period was 16 months (9-18 months). During the follow-up examinations, the orthopaedic knee score (OAK) of the Swiss Society of Orthopaedics (SGO) was assessed. To improve objectivity, one experienced investigator documented the a.-p. drawer with the “Kneelax3” machine in comparison to the uninjured contralateral side.
21 Patients injured their ACL during sport activites and 1 while at work. The mean time from injury to the operation was 15,5 days (5-37 days). We found additional meniscus injuries in 6 patients. The patients were hospitalized for a of mean 1,5 nights (1-3 nights). The average return-to-work time was 8,8 weeks (2-20). We had 2 patients lost to follow-up and 5 patients required revision (4 ACL reconstructions, 1 mobilisation after stiffness). Orthopaedic knee score showed a mean of 91,5 points out of 100 (78-98 points) and the a.-p. drawer difference compared to the uninjured side was a mean of 2,86 mm (0,99-5,90 mm).
The “Healing response” is an easy procedure to carry out without any additional iatrogenic trauma and is minimally invasive compared to reconstruction methods. However, our revision rate of 23% is relative high. Thus it has to be discussed if this procedure is the best treament approach in for highly active young patients. In considering other investigations with elderly study groups and better results, it appears that the use of the “healing response” procedure is most appropriate for patients with an lower level of activity and higher age.
© 2007 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.