Endoscopic bone-patellar-tendon-boneanterior cruciate ligament reconstruction: Long-term follow-up

This study was performed to evaluate the results of endoscopic anterior cruciate ligament (ACL) reconstruction using bone-patellar-tendon-bone at a long-term follow-up. This is a case series type of study. We reviewed 131 arthroscopically ACL reconstructions, with a long-term follow-up of 7.1 years. All patients were reviewed using the IKDC score, full weight-bearing, bilateral X-rays, Kt-1000 evaluation. At the follow-up we obtained 47% A, 40% B, 11% C and 2% D overall IKDC scores. Analyzing the Kt-1000 evaluation we had good-excellent results in 87.4% of the one-incision group and 83.9% in the two incision group. At follow-up we also tested lower limb motor control in 77 patients using a mobile platform. We obtained excellent result for 91% in the bipodalic static test, 91% in the right static test, 93% in the left static test, and 62% in the bilateral dynamic test. Subjectively, 123 of the 126 (97.6%) patients stated that they were satisfied with the surgical reconstruction. Unsatisfactory cases did not show significant errors or mismatched tunnels at the X-ray evaluation. The fair and poor results were due to anterior knee pain and clinical laxity. We think that they might derive in part from errors when tensioning the graft or biological problems, that consist in loosening of ligamentization of the graft. The ACL reconstructed knee showed good results and a good lower limb motor control. A precise technique and an accelerated rehabilitation program is mandatory in ACL arthroscopically assisted reconstruction.