Intraarticular anterior cruciate ligament reconstruction in the symptomatic arthritic knee

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Abstract
We reviewed a consecutive series of young sympto matic patients with chronic anterior cruciate ligament- deficient knees to determine if an autogenous patellar tendon graft reconstruction decreased their symptoms and increased the stability of the knee. All patients had radiographic evidence of posttraumatic arthritis. Thirty- three patients met our criteria for inclusion in the study. Time from injury to reconstruction of the anterior cru ciate ligament averaged 105 months. All patients under went an accelerated rehabilitation program designed to help them regain full range of motion as soon as pos sible. Preoperative and postoperative range of motion, strength, stability, and subjective evaluations were compared. Followup averaged 44.8 months. Follow-up range of motion was not significantly different from preoperative measurements (P = 0.51). Postoperative stability, as measured by KT-1000 arthrometer maxi mum manual test, averaged 2.7 mm versus 8.4 mm preoperatively (P < 0.001). Isokinetic testing revealed no difference in the quadriceps strength after recon struction (P = 0.99). Patients' subjective scores on a modified Noyes questionnaire improved for pain, sta bility, and activity level, with a total improvement from 55 to 81 points. Although the procedure and rehabili tation were successful in providing stability and de creasing pain, patients were still encouraged to limit high-impact athletic and occupational activity.