Intraarticular anterior cruciate ligament reconstruction in the symptomatic arthritic knee

We reviewed a consecutive series of young symptomatic patients with chronic anterior cruciate ligament-deficient knees to determine if an autogenous patellar tendon graft reconstruction decreased their symptoms and increased the stability of the knee. All patients had radiographic evidence of posttraumatic arthritis. Thirty-three patients met our criteria for inclusion in the study. Time from injury to reconstruction of the anterior cruciate ligament averaged 105 months. All patients underwent an accelerated rehabilitation program designed to help them regain full range of motion as soon as possible. Preoperative and postoperative range of motion, strength, stability, and subjective evaluations were compared. Followup averaged 44.8 months. Follow-up range of motion was not significantly different from preoperative measurements (P = 0.51). Postoperative stability, as measured by KT-1000 arthrometer maximum manual test, averaged 2.7 mm versus 8.4 mm preoperatively (P < 0.001). Isokinetic testing revealed no difference in the quadriceps strength after reconstruction (P = 0.99). Patients' subjective scores on a modified Noyes questionnaire improved for pain, stability, and activity level, with a total improvement from 55 to 81 points. Although the procedure and rehabilitation were successful in providing stability and decreasing pain, patients were still encouraged to limit high-impact athletic and occupational activity.