Eighty-four percent of males who had ACL knee (anterior cruciate ligament) reconstruction with a patellar tendon (the tendon that attaches the knee to the front of the tibia or shin bone) graft continue at a high level of activity 15 years later, according to a study presented today at the American Orthopaedic Society for Sports Medicine's Specialty Day in New Orleans, Louisiana (March 13). Additionally, these patients have not developed severe osteoarthritis and their knees remain stable.
"We have done this procedure for many years and this study looks at patients as far back as 17 years," said Leo Pinczewski, MD, corresponding author and consultant surgeon at the North Sydney Orthopaedic & Sports Medicine Centre, Wollstonecraft, Australia. "The results of this technique, which was new almost 20 years ago, were excellent at five years, outstanding at 10 years and still very, very good at 15 years. Patients went back to sport quickly, had an easy rehabilitation with no brace and were frequently walking straight away."
The goal of ACL knee surgery is to stabilize the knee with a short rehabilitation letting patients get back to an active lifestyle. Long-term, the surgery aims to prevent additional damage to the knee and minimize osteoarthritis.
But Dr. Pinczewski's success with the procedure almost didn't occur, he noted. In 1989, Dr. Pinczewski had gone to a medical seminar to hear Tom Rosenberg, MD, of Salt Lake City, Utah, who had pioneered a surgery to arthroscopically reconstruct the ACL using the patellar tendon. Previously, this knee surgery had been an "open" (not minimally invasive) procedure with a long rehabilitation and a high incidence of osteoarthritis. All he was able to obtain was the procedure summary from literature left at the lecture.
"So, I worked out how to do it from the abstract," said Dr. Pinczewski. "Little did I know that I got it wrong, according to Dr. Rosenberg's method. But, in fact, it proved to
|Contact: Lisa Weisenberger|
American Orthopaedic Society for Sports Medicine