DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20164166

A study on the functional outcome of arthroscopic anterior cruciate ligament reconstruction done with bone patellar tendon bone graft using the IKDC score

Vineet Thomas Abraham, Krishnagopal R., Vamsi Kondreddi, Swagat Mahapatra

Abstract


Background: ACL injuries result in persistent recurrent instability and increased risk of meniscal tears and intra-articular damage, leading on to degenerative changes in the knee. There are many studies about ACL reconstruction using bone patellar tendon bone graft (BPTB) and its outcome, but there is not enough literature on the subjective assessment following reconstruction. We decided to do a study of the patient’s subjective outcome as per the International knee documentation committee score (IKDC) and other clinical parameters following ACL reconstruction using the BPTB graft.

Methods: This was a prospective study consisting of 50 patients who presented with ACL injury and underwent arthroscopic ACL reconstruction using BPTB graft in our hospital in the period from May 2008 to July 2010.  Patients were followed at regular intervals at 4 weeks, 8 weeks, 3 months & 6 months and 1 year. Patients were assessed at every visit with clinical tests and IKDC subjective assessment score.

Results: 50 patients with ACL insufficiency underwent ACL reconstruction. Postoperative knee flexion improved; the mean flexion was 131.70 with standard deviation of 6.534, which was significant. The mean preoperative IKDC was 56.97 and standard deviation of 9.188 and postoperative IKDC score was 92.33 and standard deviation 5.198 which showed a marked improvement and was statistically significant. The complications included; 8 patents with anterior knee pain, 1 case of patellar fracture while harvesting graft, which healed with wiring and 2 patients, had re-rupture of ACL due to road traffic accident.

Conclusions: ACL reconstruction with BPTB graft showed a significantly good subjective outcome on assessment using IKDC score. Isolated ACL reconstruction showed a better subjective outcome compared to the patients who had associated meniscal injury.

Keywords


Anterior cruciate ligament, BPTB graft, IKDC score

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References


Daniel DM, Stone ML, Dobson BE. Fate of the ACL-injured patient. A prospective outcome study. Am J Sports Med. 1994;22:632-44.

Miyasaka KC, Daniel DM, Stone ML, Hirshman P. The incidence of knee ligament injuries in the general population. Am J Knee Surg. 1991;4:3-8.

Bobic V. Current concepts in anterior cruciate ligament reconstruction. Am J Knee Surgery. 1992;10:241-7.

Arnold JA, Coker TP, Heaton LM, Park JP, Harris WD. Natural history of anterior cruciate tears. Am J Sports Med. 1979;7:305–13.

Fetto JF, Marshall JL. The natural history and diagnosis of anterior cruciate ligament insufficiency. Clin Orthop. 1980;147:29–38.

Shelbourne KD, Nitz P. Accelerated rehabilitation after anterior cruciate ligament reconstruction. Am J Sports Med. 1990;18:292–9.

Johnson RJ, Beynnon BD, Nichols CE, Renstrom PA. The treatment of injuries of the anterior cruciate ligament. J Bone Joint Surg Am. 1992;74:140–51.

Tow BP, Chang PC, Mitra AK, Tay BK, Wong MC. Comparing 2-year outcomes of anterior cruciate ligament reconstruction using either patellar tendon or semitendinosus-tendon autografts: A non-randomised prospective study. J Ortho Surg. 2005;13(2):139-46.

Jomha NM, Pinczewski LA, Clingeleffer A, Otto DD. Arthroscopic reconstruction of the anterior cruciate ligament with patellar-tendon autograft and interference screw fixation. The results at seven years. J Bone Joint Surg Br. 1999;81:775–9.

Struewer J, Frangen TM, Ishaque B, Bliemel C, Efe T, Ruchholtz S, et al. Knee function and prevalence of osteoarthritis after isolated anterior cruciate ligament reconstruction using bone-patellar tendon-bone graft: long-term follow-up. Int Orthop. 2012;36(1):171-7.

Wu WH, Hackett T, Richmond JC. Effects of meniscal andarticular surface status on knee stability, function, and symptoms after anterior cruciate ligament reconstruction: a long-termprospective study. Am J Sports Med. 2002;30:845–50.

Corrigan JP, Cashman WF, Brady MP. Proprioception in the cruciate deficient knee. J Bone Joint Surg [Br]. 1992;74 :247–50.

Barrett DS. Proprioception and function after anterior cruciate ligament reconstruction. J Bone Joint Surg [Br]. 1991;73(5):833–7.

Barrett DS, Cobb AG, Bentley G. Joint proprioception in normal, osteoarthritic and replaced knees. J Bone Joint Surg [Br]. 1991;73 :53–6.

Hurley MV. The effects of joint damage on muscle function, proprioception and rehabilitation. Manual Ther. 1998;2:11–7.