2019 ISAKOS Biennial Congress ePoster #792
Results of Delayed ACL Reconstruction More Than Ten Years Following Initial Trauma
Amirmohammad Navali, MD, Tabriz IRAN, ISLAMIC REPUBLIC OF
Ali Naghiloo, MD, Tabriz, East Azerbaijan IRAN, ISLAMIC REPUBLIC OF
Tabriz University of Medical Sciences, Tabriz, East Azerbaijan, IRAN, ISLAMIC REPUBLIC OF
FDA Status Not Applicable
ACL reconstruction in patients with delay of more than 10 years following the primary trauma can results in acceptable improvement in knee scores and patient satisfaction.
Anterior cruciate ligament is a critical part of biomechanics of knee joint and long lasting knee instability due to ACL tear increases the risk of meniscal and articular cartilage injury. The purpose of this study was to assess the results of ACL reconstruction in patients with delay of more than 10 years after the primary trauma.
In a prospective cohort study from Sep 2012 to Dec 2015, 43 patients (39 Male and 4 Female) who underwent ACL reconstruction with a delay of more than 10 years were enrolled. The mean age was 38 (range: 31 to 54 years). Lysholm, IKDC, and KOOS scores were recorded prior to surgery and at the final follow up. The Tegner activity level before and after injury and at the last follow up were recorded. The anterior translation of tibia was measured using KT 1000 and a motorize arthrometer. The meniscal or chondral lesions were evaluated according to the patients’ arthroscopic records. Patients’ satisfaction VAS scores were recorded. Kellgren and Lawrence system for classification of osteoarthritis of knee was used and grade 3 and 4 patients were not enrolled in the study. The level of significance was set at P < .05
The mean time interval between primary trauma and ACL reconstruction surgery was 143 months (range: 123 to 216 months) and the mean follow-up was 37 months (range: 24 to 67 months). Thirty nine cases (90/7%) had chondral lesions which include 19 cases of grade III/IV and 20 cases of grade I/II lesions. Meniscal tear was present in 35 patients (81.4%) including 21 cases of medial meniscus, 4 cases of lateral meniscus and 10 cases of combined medial and lateral meniscus tears. Only two cases (4.6%) had isolated ACL tear without additional meniscal or chondral lesions. The mean KT-1000 arthrometer side-to-side difference was 3.7mm. The mean arthrometer side-to-side difference in 134 N posteroanterior force was 4.2mm. Significant improvement were noticed in Lysholm, IKDC, KOOS and Tegner activity scores and pivot shift test. The mean Patients satisfaction VAS score was 7.9 out of 10.
Longstanding ACL tear leads to increased occurrence of meniscal and cartilage injuries. Delayed ACL reconstruction in these group of patients can results in acceptable improvement in knee scores and patient satisfaction.