The conservative treatment of the anterior cruciate deficient knee

Seventy-nine recreational athletes (average age, 26 years) with complete ACL tears were treated with nonligamentous arthroscopic surgery, monitored rehabilitation, functional bracing, and activity modification. The average followup was 52 months (range, 36 to 102 months). Six (8%) patients ultimately underwent ligament reconstruction and were considered failures of nonreconstructive treatment. The remaining 73 patients were the subject of detailed analysis. There were 9 (11%) excellent, 25 (32%) good, 17 (22%) fair, and 28 (35%) poor results. Although 71 patients (97%) were satisfied with their knee for activities of daily living, only 36 (49%) were satisfied with their knee for sports. Twenty-nine (40%) had significantly modified their athletic activities. Age, sex, interval from injury to treatment, associated meniscal tears (49 or 67%), and articular cartilage damage (21 or 29%) had no apparent effect on the outcome. Poor results were noted in 29 (40%) patients with significant pivot shifts. Multiple repeat injuries, repeat arthroscopy, isokinetic deficits, and increased length of followup were also associated with poor results.