MacIntosh-Jones reconstruction for the unstable knee

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomechanical Engineering

Background:

• Anterior cruciate ligament (ACL) rupture is a common knee injury, particularly in athletes.
• Restoring knee stability and function after ACL rupture is crucial for returning to pre-injury activity levels.
• Various surgical techniques exist for ACL reconstruction, each with its own outcomes and limitations.

Purpose of the Study:

• To evaluate the clinical outcomes of ACL reconstruction using a free one-third patellar tendon graft.
• To assess the effectiveness of combining this graft with a lateral extra-articular tenodesis for knee stability.
• To determine patient satisfaction and return to sport rates following this combined surgical approach.

Main Methods:

• A retrospective review of 45 patients who underwent ACL reconstruction with a patellar tendon graft and lateral extra-articular tenodesis.
• Patients' average age was 26.4 years, with a mean follow-up of 3.2 years.
• Clinical assessment of knee stability, patient-reported satisfaction, and return to sporting activity were recorded.

Main Results:

• Knee stability was achieved in 93% (42 out of 45) of patients based on clinical evaluation.
• Overall patient satisfaction was reported at 73%.
• 84% (38 out of 45) of patients successfully returned to social or competitive sporting activities. Unsatisfactory outcomes were linked to delayed reconstruction.

Conclusions:

• ACL reconstruction utilizing a free one-third patellar tendon graft combined with lateral extra-articular tenodesis provides high rates of knee stability and return to sport.
• Prompt surgical intervention appears critical for optimal patient outcomes.
• This surgical technique demonstrates a favorable profile for restoring function in patients with ACL ruptures.