Arthroscopic evaluation of anterior cruciate ligament reconstructions

Abstract

Fourteen patients who underwent anterior cruciate ligament (ACL) reconstruction, using fascia lata or patellar tendon, were examined arthroscopically at a mean time of 16 months following surgery. The postoperative care and rehabilitation program was standardized for all patients. Eleven of these 14 patients were recalled for a functional evaluation. Nine of these 11 patients were satisfied with the outcome of their reconstruction. Two patients complained of an occasional giving way of the knee. The arthroscopic findings were disappointing. Four patients appeared to have viable ligamentous structures in the intercondylar notch. Four patients had lax ligamentous tissue in the notch. In other cases, the notch was filled with varying degrees of amorphous scar tissue. The tissue was tested by palpation with a probe and with an anterior drawer test applied. The scar tissue did develop tension and give a firm end point to the drawer test. Other arthroscopic findings included instances of Grade II, III, and IV chondromalacia of the articular cartilage, adhesions, and capsular scarring not seen at the time of original surgery. While the patient satisfaction and functional results were generally good, we were disappointed with the arthroscopic findings. Based on the generally poor quality of the reconstructed tissue and the articular cartilage lesions, we have changed our surgical technique and postoperative regime.