Outcome of Endoscopic ACL Reconstruction Using Autogenous Patellar Bone-Tendon-Bone Graft

Purpose: To correlate the clinical outcome and the degenerative changes of the knee with age, sex and the duration of injury after endoscopic anterior cruciate ligament reconstruction using autogenous patellar bone-tendon-bone graft in 84 patients with 84 knees with two- to six-year follow-up. Materials and Methods: This series included 84 patients (64 males and 20 females) with an average age of 28 years (range 15-57) and an average followup of 38 months (range 24-74). The average time from injury to surgery was 16 months (range 0.5- 68). The evaluation parameters included functional assessment, ligament laxity and radiographs of the knee. The correlation of clinical outcome and the rate of degenerative changes of the affected knees with sex, age and the duration of injury were analyzed statistically. Results: The overall results were 50% excellent, 29.8% good, 19% fair and 1.2% poor. Better functional outcome was observed in knees with surgery in less than 6 months from the time of injury. However, there was no correlation of the clinical outcome with sex and age over 40 years old. Despite functional improvements, approximately 1/3 of the knees showed mild (＜5 mm) ligament laxity postoperatively. The incidence of degenerative changes of the affected knees was 66%, with a higher rate in chronic ACL and knees with meniscectomy and a lower rate in acute ACL deficiency kness. Conclusion: Endoscopic ACL reconstruction using autogenous patellar bone-tendon-bone graft produced 80% good or excellent esult with low complications. The functional outcome and the incidence of degenerative change showed a positive correlation with the duration from the time of injury to surgery and meniscectomy, but a negative correlation with sex and age over 40 years old. Therefore, early surgical ACL reconstruction with preservation of the meniscus is strongly recommended in knees with ACL injury.

並列關鍵字

Anterior cruciate ligament ； Reconstruction ； Patellar bone-ten-don-bone graft

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