The potential benefit of thermal shrinkage for lax anterior cruciate ligaments

Radiofrequency thermal shrinkage of the anterior cruciate ligament (ACL) injured knee is a relatively recent treatment. The purpose of this study was to retrospectively analyse the results in a cohort of 32 patients with a minimum follow-up of 12 months (range 12-37 months). Cases were acute (1) or chronic (31), involving either a native or reconstructed ligament. Native ACL injuries were: lax but intact (12 + 1 acute), partial tears with remaining intact femoral attachment (4) or completely torn and attached to the posterior cruciate ligament (PCL) (6). Reconstructions were: Hamstrings (3), Bone-Patella Tendon-Bone (5) or allograft (1). We also recorded concomitant pathology, function status, Lysholm and Tegner scores and KT2000 values. The procedure was successful in limiting instability overall in 72% (23/32), and in particular 44% of reconstructed ligaments (4/9). There was no correlation of results to the treatment of co-existent pathology. The clinical scores remained high in successful cases although sporting function did reduce by follow-up. We conclude that despite these results the technique is still of value in appropriately selected, counselled and rehabilitated individuals. It is a safe technique that may avoid the necessity to proceed to reconstruction and can be considered as a planned procedure or as an adjunct to other therapy for instability at the time of arthroscopy for other pathology.