ACL reconstruction using bonepatellar tendonbone

Authors: P Hertel H Behrend T Cierpinski V Musahl G Widjaja

Publish Date: 2005/02/03

Volume: 13, Issue: 4, Pages: 248-255

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Abstract

Multiple techniques for anterior cruciate ligament ACL reconstruction are currently available most of which use hardware or resorbable material for fixation of the graft inside or outside the bony tunnels In this study the longterm results of 95 patients at a mean followup of 107 years were assessed The ACL was reconstructed using a patellar tendon autograft with a pressfit fixation Between 1987 and 1991 159 patients were operated by the senior author PH 95 could be seen for followup Evaluation included detailed history physical examination functional knee ligament testing KT1000 arthrometer testing the IKDC standard evaluation form Lysholm Flandry and Tegner scoring systems Radiographs were obtained preoperatively and at followup to assess the grade of osteoarthritis Subjectively none of the patients that were seen for followup complained of instability Numbness of the skin was reported by 54 of the patients and pain during knee walking was described as mild in 25 and severe in 2 The mean Flandry score was 243 max 280 The mean Lysholm score was 932 at followup and the Tegner activity level was 68 preinjury and 60 postoperatively The average KT1000 sidetoside difference was 18 mm on a manual maximum pull The IKDC knee scoring revealed 84 of the patients with normal A or nearly normal B knee joints 15 were C 1 was D Radiographically joint space narrowing was found in 19 15 and 25 for the patellofemoral medial and lateral compartments respectively Meniscus surgery was a determining factor This study presents longterm clinical data on a pressfit fixation for ACL reconstruction Results were excellent and good in more then 80 of the followed patients The advantages of the pressfit fixation are direct bonetobone healing of the graft decreased donor site morbidity costeffectiveness and ease for revision surgery

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