Acute uncomplicated anterior knee instability. 2-5 year follow-up of surgical treatment

A retrospective review of 158 acute anterior cruciate ligament injuries without additional ligamentous lesions was conducted. The follow-up study included 127 patients (80%), 109 of whom were personally examined 2-5 years after surgery. In the largest group proximal ruptures were found and treated with reinsertion. The other group had intraligamentary ruptures which were augmented with semitendinosus tendon. A modified Ellison procedure was routinely performed. Postoperative treatment was cast-free and included immediate physiotherapy using a functional brace. Examination at follow-up included Lysholm score, Tegner activity scale, instrumented testing with a KT-100 arthrometer and measurement of isometric leg muscle strength in four different positions. Among other clinical manoeuvres, the Lachman test and pivot shift testing were performed. No significant differences were found between the two groups in subjective evaluation, stability, consecutive meniscal lesions or patella symptoms. The average anterior dislocation difference at 89 N was 2 mm in both groups. Pivot shift was definitely absent in 88% of one group and 90% of the other. Almost no meniscal problems were noted, but 15% of the patients complained of patellofemoral pain.