Bob's ACL WWWBoard On-Line Knee Library |
Click here to return to the main page of the Knee Library's Research Section.
ACL Reconstruction in the Arthritic Knee
See also Long-term Consequences of ACL Injuries, The Degenerate Knee: Arthritis, Articular Cartilage, Bone Bruising, and Chondrosurgery, ACL Reconstructions via Patellar Tendon Autografts, ACL Reconstructions via Soft-Tissue (e.g. Hamstring) Autografts, ACL Reconstructions via Allografts.
For a brief overview of knee anatomy, physiology, and biomechanics, please click here.
Anterior cruciate ligament reconstruction with autogenous patellar tendon graft in patients with articular cartilage damage, Frank Noyes and Sue Barber-Westin; American Journal of Sports Medicine, Baltimore, Maryland; September-October 1997, Vol 25/5, p.626-634. Comments: This article makes it clear that even in cases where substantial articular-cartilage deterioration has occurred, ACL reconstruction remains well worthwhile.
Anterior cruciate ligament (ACL)-deficient knee with degenerative arthrosis: treatment with an isolated autogenous patellar tendon ACL reconstruction, K. Donald Shelbourne and Keith C. Stube; Knee Surgery, Sports Traumatology, Arthroscopy; September 1997, Vol 5, p.150-156. Comments: This study shows that ACL reconstruction is still worthwhile in the moderately arthritic knee. The reconstruction, by restoring stability to the knee, prevents further instability-related damage. Arthroscopic-Assisted Allograft Anterior Cruciate Ligament Reconstruction in Patients With Symptomatic Arthrosis, Frank R. Noyes and Sue D. Barber-Westin; Arthroscopy, The Journal of Arthroscopic and Related Surgery; February 1997, Vol 13/1, p.24-32. Comments: In this superbly penetrating study, a chronic ACL tear was defined as being greater than 12 weeks from injury to reconstruction, and advanced articular-cartilage deterioration (as determined via arthroscopic viewing during ACL reconstruction surgery) was defined as gross fissuring/fragmentation of a cartilage surface extending to at least half the depth of the cartilage, or any articular-cartilage damage of greater severity. The authors, who have extensive experience in the field of treating complex ACL-and-other-damage knee situations, note that patellar-tendon autografting (i.e. tissues from the person's own body) is the preferred graft option. Allografting, while indeed usable as a first-time graft, is preferred in cases where suitable autologous graft-harvest sites have been depleted or otherwise compromised. Chronically ACL-deficient knees often harbour damage to both the articular-cartilage surfaces and the menisci. For insight into the value of meniscal repair (via careful suturing, including tears extending into the avascular central portion) in the context of ACL reconstruction (in both acutely and chronically unstable knees, and likely also harbouring articular-cartilage damage via bone-bruising), please see
A comparison of results in acute and chronic anterior cruciate ligament ruptures of arthroscopically assisted autogenous patellar tendon reconstruction, by Noyes and Barber-Westin, in the ACL Reconstructions via Patellar Tendon Autografts Subsection. Click here to return to the Main Entrance Page of the Knee Library.
Looking for the Main Index Page of Bob's ACL WWWBoard? Click here!
Site Terms of Use and Aspects of Copyright
To find recent postings on Bob's ACL WWWBoard, use the Search Engine.
To find older postings on Bob's ACL WWWBoard, use the On-Line Archive.