Lateral extra-articular knee reconstruction: long-term patient outcome and satisfaction

Fifty-two patients who had an extraarticular reconstruction for anterior cruciate ligament (ACL) insufficiency were interviewed at an average of 11.4 years after their reconstruction. During the follow-up period, 4 patients (8%) had intra-articular reconstructions for persistent instability or re-injury, and another 4 (8%) had arthroscopic surgery for meniscal lesions. The mean Lysholm score at follow-up was 76.9. Of the 52 patients, 5 had had subsequent surgery during the follow-up period. In the remaining 47 patients, the results were excellent in 14 (29%), good in 10 (23%), fair in 7 (15%), and poor in 16 (33%). Patients operated on acutely (<6 weeks after injury) had a mean score of 82, whereas patients operated on more than 6 weeks after injury had a mean score of 75. Adding those patients who required subsequent reconstructions for persistent instability (4 knees) and those who obtained fair and poor results yielded an alarming rate of unsatisfactory results (52%). On the basis of these findings, we believe the lateral extraarticular reconstruction is not an acceptable form of treatment for the functionally unstable knee.