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Document Title: Noyes-AJSM-Sep97.shtml
Article Title: Anterior cruciate ligament reconstruction with autogenous patellar tendon graft in patients with articular cartilage damage
Authors: Frank R Noyes, MD, Sue D Barber-Westin, BSc
Publication: American Journal of Sports Medicine, Baltimore, Maryland
Date: September-October 1997
Volume 25, Number 5, pages 626-634
Keywords: ACL reconstruction, arthritic knee, arthrosis, patellar-tendon autograft, articular-cartilage damage.
(Reference-denoting numbers appear in the same font and point size as the document text. As with all Knee Library documents, this article is provided in full-text form, complete with all figures and tables.)
Comments: This article makes it clear that even in cases where substantial articular-cartilage deterioration has occurred, ACL reconstruction remains well worthwhile.
ABSTRACT
To test if anterior cruciate ligament reconstruction with autogenous patellar tendon can alleviate symptoms and functional limitations and increase activity levels in patients with advanced articular cartilage damage, we looked at 53 patients with arthroscopically documented cartilage damage. In this group, a mean of 7.5 years had elapsed between the original injury and the reconstruction, and 90 prior operative procedures had been done. Postoperatively, all patients had immediate motion and early functional rehabilitation. The results were assessed with the Cincinnati Knee Rating System. At followup (mean, 27 months), significant improvements were found for pain, swelling, giving way, functional limitations with daily and sports activities, and the overall rating score. Forty-two patients (79%) had returned to some type of athletic activity. Only three patients (6%) had failed results. In the patients' own ratings of the overall knee condition, 8 of 51 (16%) rated their knees as normal, 28 (55%) as very good, 7 (14%) as good, 5 (10%) as fair, and 3 (6%) as poor. We concluded that the majority of patients benefited from the arthroscopically assisted anterior cruciate ligament reconstruction because it decreased episodes of giving way with daily activities and increased activity without aggravating the preexisting arthrosis.
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