Central third bone-patellar tendon-bone arthroscopic anterior cruciate ligament reconstruction: a 4-year follow-up

This prospective study reports the 4-year follow-up results of 56 patients (44 males and 12 females) who underwent arthroscopic reconstruction of the anterior cruciate ligament (ACL) using a central third bone-patellar tendon-bone free autologous graft and assesses the mid-term effectiveness of this technique. Mean patient age was 30.2 years (range: 17-44 years). Sports injuries were the primary cause of ACL deficiency in 93% of patients. All knees had an isolated ACL tear, and 31 had associated meniscal or chondral lesions. Patients in the acute phase did not undergo surgery for 3-4 weeks. In patients with subacute and chronic ACL ruptures, the mean interval between injury and surgery was 62 weeks (range: 8-104 weeks). According to the International Knee Documentation Committee grading system, 53 (95%) knees were considered normal or nearly normal postoperatively. Improvement by at least 1 grade was noted in 12 knees, 30 knees had an improvement of at least 2 grades, 12 knees had a 3-grade improvement, and 1 had a grade that remained unchanged. One knee deteriorated from a grade C to a grade D, which was attributed to graft lysis 1 year postoperatively. For best results, subacute reconstruction between 3 and 5 weeks postinjury is recommended.