Summary

To evaluate clinic-outcome and osteoarthritis progression in long term after ACL reconstruction with semitendinosus and gracilis tendons knot and bone lock-bolt implant fixation technique.

Abstract

Background

To avoid disadvantages related to fixation devices, a hardware-free ACL reconstruction technique using semitendinosus and gracilis tendons knot and bone lock-bolt implant fixation was developed. The aim of this study was to evaluate clinic-outcome and osteoarthritis progression in long term after ACL reconstruction with this technique.

Methods

28 patients met inclusion/excusion criteria for this study. The patients were assessed preoperatively and at 10.5 years after surgery with IKDC Knee Evaluation Form, Lysholm knee score, Tegner activity scale and radiographs.

Results

Good clinical outcomes and self-reported assessments were documented, and remained good 10 years after the procedure. The mean Lysholm and Tegner scores improved from 58.7 ± 15.5 and 4.1 ± 1.0 preoperatively to 85.4 ± 6.6 (p = 0.004) and 6.9 ± 2.5 (p = 0.005). The IKDC subjective score improved from 59.1 ± 8.2 to 81.2 ± 8.1 (p = 0.003). According to IKDC objective score, 76% of patients had normal or nearly normal knee joints at follow-up. Grade 0 or

Results

were seen in 85% of patients on laxity testing. Degenerative changes were found in 74% of patients. There was no correlation between arthritic changes and stability of knee and subjective evaluation (p>0.05).

Conclusions

ACL reconstruction with this tendons knot and bone lock-bolt implant fixation technique allows achieving good clinical evaluation up to 10 years. With advantages of unlimited tendon-to-bone healing, cost effectiveness, avoidance of disadvantages associated with hardware, this technique can be safely applied in clinical practice and enables patients to return to preinjury activities.