Quadrupled semitendinosus anterior cruciate ligament reconstruction: 5-year results in patients without meniscus loss

Purpose: The purpose of this study was to determine the mid-term (minimum 5-year) results of isolated primary anterior cruciate ligament (ACL) reconstructions with intact or repaired menisci. Type of Study: Case series. Methods: Of 184 ACL reconstructions from April 1990 to February 1992, 33 initially met the inclusion criteria of primary reconstruction with quadrupled semitendinosus tendon and without extra-articular reconstruction or meniscus removal. Patients with known traumatic rerupture of the graft with revision (I case) or subsequent meniscectomy (1 case) were excluded from the study. Twenty of the remaining 31 patients were available for follow-up at an average of 5.7 years after surgery. At follow-up, a comprehensive knee examination, KT-1000 arthrometry, radiography, functional testing, and isokinetic strength testing were performed. A subjective questionnaire, Tegner scale, and IKDC evaluation were administered as well. Four patients who were unable to come in for follow-up returned a knee-assessment questionnaire. Results: Arthrometric anterior tibial translation was reduced from a preoperative average of 6.3 +/- 2.8 mm (manual maximum side-to-side difference) to an average of 0.0 +/- 1.3 mm (range, -2.5 to 2 mm). Radio graphic ally, I patient experienced mild narrowing in the lateral compartment. Tegner activity level was maintained at the preinjury level in nearly half the patients. Isokinetic strength deficits were less than 10%; 17 (85%) of the patients had a normal or nearly normal result as graded by the IKDC scoring system. Conclusions: The above data show minimal morbidity, a low reoperation rate, and excellent clinical outcome. Because the stability of the knee persists beyond 5 years after ACL reconstruction, patients are able to maintain preinjury activity levels without reinjury.