Acute anterior cruciate ligament repair

Sixty-six consecutive patients with acute repair of a complete isolated anterior cruciate ligament (ACL) injury were retrospectively reviewed to evaluate the effectiveness of the authors' surgical technique. All patients noted either a pop, acute swelling, or had acute disability after injury with 58% experiencing all three signs and symptoms. Preoperative testing without anesthesia revealed 95% of patients to have either a positive modified Losee or Lachman test. Postoperative results were obtained by questionnaire in 41 of 42 patients (98%) with a minimum two-year follow-up period. Physical examination was completed in 32 (76%) and arthrometer testing in 30 (71%) patients. Subjective results were good or better in 91%. No patients had buckling or meniscal loss postoperatively. Patellofemoral pain, however, was significant in 15% and severe in 2%. Postoperative functional results were good or better in 78% with all patients participating in sports, 76% in "at risk" sports. A Performance Quotient (P.Q.) was developed to more accurately correlate preinjury and postoperative function. The average P.Q. was 0.87. Objective results were good or better in 100%. Stability was within normal limits by clinical observation in 88%, and by arthrometer testing in 87%. ACL repair is recommended in the young patient who is active in "at risk" sports and who is unwilling to modify activities and willing to undergo a one-year rehabilitation period.