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Late results following proximal reinsertion of isolated ruptured ACL ligaments

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Abstract

Between 1982 and 1984, 49 patients with fresh isolated proximal ruptures of the anterior cruciate ligament (ACL) were operated on in the Trauma Hospital, Salzburg. The operation was performed within 1 week of trauma. The operational technique used was proximal reinsertion of the ruptured ACL alone. Postoperatively the knee was immobilized for 6 weeks in an above-theknee plaster cast. We were able to re-examine 42 of the 49 patients 5–7 years after injury. In addition to a clinical examination, testing with a KT-1000 arthrometer was performed. The objective and subjective results we found were evaluated using the Lsyholm score and OAK knee evaluation form. We found 12 (29%) absolutely stable knee joints. We accepted a KT-1000 result of up to 3 mm as satisfactory, and 81% of our patients were in this category. The same percentage (81%) scored between 85 and 100 points on the Lysholm scale. Only 52% scored over 90 points on the OAK form. Subjectively only 6 patients (14%) were dissatisfied with their result.

Zusammenfassung

Zwischen 1982 and 1984 wurden im Unfallkrankenhaus Salzburg 49 Patienten mit frischen isolierten proximalen Rupturen des vorderen Kreuzbandes operiert. Die Operation erfolgte bei allen Patienten innerhalb der 1. Woche nach dem Trauma. Die von uns durchgeführte Operationstechnik war die alleinige proximale Reinsertion des gerissenen vorderen Kreuzbandes über 2 Bohrkanäle transossär bzw. über einen transossären Bohrkanal und “over the top”. Die postoperative Ruhigstellung erfolgte im Oberschenkelgehgipsverband für insgesamt 6 Wochen. 42 unserer 49 operierten Patienten konnten wir zwischen 5 und 7 Jahre postoperativ nachuntersuchen. Dabei wurde neben der klinischen Stabilitätsprüfung auch eine Stabilitätsprüfung mit dem KT 1000 durchgeführt. Die objektiven und subjektiven Ergebnisse wurden nach dem Lysholm Scale und nach dem OAK-Bogen ausgewertet. Dabei fanden wir in 29% absolut stabile Kniegelenke. Gibt man sich mit einem KT 1000 Meßwert bis zu 3 mm zufrieden, so fielen 81% unserer Patienten in diese Kategorie. Der Lysholm Score lag ebenfalls bei 81% und über 85 Punkten. Im OAK-Bogen wiesen lediglich 52% über 90 Punkte auf. Subjektiv waren nur 14% unserer Patienten mit dem Ergebnis unzufrieden.

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Correspondence to F. Genelin.

Additional information

Dedicated to Prof. Dr. H. Möseneder on his 60th birthday

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Genelin, F., Trost, A., Primavesi, C. et al. Late results following proximal reinsertion of isolated ruptured ACL ligaments. Knee Surg, Sports traumatol, Arthroscopy 1, 17–19 (1993). https://doi.org/10.1007/BF01552153

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Key words

  • Proximal ACL reinsertion
  • Late results