Long-term results of anterior cruciate ligament reconstruction using ilio-tibial tract and semitendinosis tendon

During the 3-year period from June 1984 to July 1987, 115 anterior cruciate ligament reconstructions were performed by a combined intra- and extra-articular technique using the anterior three-quarters of the ilio-tibial band and the semitendinosis tendon. Post-operative rehabilitation included limited mobilization in flexion for 6 weeks post-surgery. Eighty-four knees (78% follow-up) were reviewed at a mean of 8 years (range 6.3-9.7 years). The long-term results of surgery were assessed using the Lysholm score, Noyes activity rating, the International Knee Documentation Committee (IKDC) knee ligament standard evaluation and manual maximum KT-1000 side-to-side difference measurements were made. In addition 45 knees were examined radiographically. Reconstruction within 6 weeks of injury led to a significantly higher chance of concurrent meniscal trauma being suitable for repair (P = 0.002). At early reconstruction coincidental macroscopic chondral damage was noted in 23% and limited to the patella while at delayed reconstruction 45% of knees showed chondral damage which also involved tibio-femoral compartments in some cases. Overall 87% returned to their pre-injury sporting level and only one ceased through knee problems. Ninety-three percent had a manual maximum KT-1000 side-to-side difference at final review no greater than 3 mm. The Lysholm score rated results as 91% excellent or good while the overall IKDC evaluated 85% as normal or near normal, 14% abnormal and 1% tone case) as severely abnormal. Twenty-seven percent of acute and 10% of delayed reconstructions developed some degree of arthrofibrosis (P = 0.049) and this significantly predisposed the knee to early degenerative change (P = 0.002). (C) 2000 Elsevier Science B.V. All rights reserved.