Isolated total ruptures of the anterior cruciate ligament - a clinical study with long-term follow-up of 7 years

• Published in: Scandinavian journal of medicine & science in sports 1999-04, Vol.9 (2), p.114-119
• Main Authors: Scavenius, M., Bak, K., Hansen, S., Nørring, K., Jensen, K. H., Jørgensen, U.
• Format: Article
• Language: English
• Subjects: ACL; activity level; Adolescent; Adult; Anterior Cruciate Ligament - physiopathology; Anterior Cruciate Ligament - surgery; Anterior Cruciate Ligament Injuries; Arthroscopy; Athletic Injuries - physiopathology; Athletic Injuries - therapy; Biological and medical sciences; Diseases of the osteoarticular system. Orthopedic treatment; Endoscopy; Female; Follow-Up Studies; Humans; isolated total rupture; Joint Instability - etiology; Joint Instability - physiopathology; knee functiion; Knee Joint - physiopathology; Longitudinal Studies; Male; Medical sciences; Menisci, Tibial - physiopathology; Middle Aged; Pain - physiopathology; Patient Satisfaction; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Range of Motion, Articular - physiology; Reoperation; Retrospective Studies; Rupture; Skiing - injuries; Soccer - injuries; Tibial Meniscus Injuries; Treatment Outcome
• ISSN: 0905-7188; 1600-0838
• DOI: 10.1111/j.1600-0838.1999.tb00219.x

Seventy patients met our inclusion criteria in this retrospective study, all with an arthroscopic/arthrotomic‐verified isolated total anterior cruciate ligament (ACL)‐rupture and a minimum follow‐up period of 3 years and no associated lesions. Due to emigration/death, 3 patients were not available for follow‐up. Of the remaining 67, 25 patients underwent secondary ACL‐reconstruction, equivalent to a failure rate of the initial non‐operative treatment of 37%. All patients were initially treated conservatively. This left 42 patients for follow‐up – 9 answered a questionnare and 33 went through follow‐up examination after a median of 7.1 years (range 3.3–14.6) including IKDC‐evaluation form. Lysholm & Tegner score, ES‐SKA‐score, clinical examination and Stryker Laxity test. In the present study all values represent the 33 patients available for follow‐up. Soccer, handball and alpine skiing were most frequently responsible for the injury. We observed in the 33 patients a decline in median Lysholm score from 100 (90–100) pretraumatic to 86 (42–100) at follow‐up, and a decrease in median Tegner values from 7 (3–9) pretraumatic to 5 (2–7) at follow‐up. All but 2 patients demonstrated a decline in Lysholm score, and only 3 patients returned to their preinjury level. According to the ESSKA‐classification, the number of “cutting‐sports performers” declined dramatically from 24 to 2. All but one patient ascribed their decline in activity to their knee status. The Stryker‐measured AP‐translocations were significantly higher on the injured knee (7.27) compared to the healthy knee (4.80) (P