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Single-Incision Endoscopic Anterior Cruciate Ligament Reconstruction Using Patellar Tendon Autograft

Minimum Two-Year Follow-Up Evaluation

Bernard R. Bach, Jr, MD, Matthew E. Levy, MD, John Bojchuk, MS, ATC, Steven Tradonsky, MD, Charles A. Bush-Joseph, MD and Nazeer H. Khan

Department of Orthopaedic Surgery, Section of Sports Medicine, Rush Medical College, Rush-Presbyterian-St. Luke’s Medical Center, Chicago, Illinois

Presented at the 22nd annual meeting of the AOSSM, Lake Buena Vista, Florida, June 1996.

Address correspondence and reprint requests to Bernard R. Bach, Jr., MD, Rush-Presbyterian-St. Luke’s Medical Center, 1725 W. Harrison St., Suite 1063, Chicago, IL 60612

We conducted a retrospective, minimum 2-year follow-up study to evaluate the effectiveness of a single-incision endoscopic anterior cruciate ligament reconstruction technique using patellar tendon autograft without extraarticular augmentation and followed by accelerated rehabilitation. One hundred three patients were evaluated (mean followup, 36 months; range, 24 to 55). There were significant improvements in physical examination test results (Lachman, anterior drawer, and pivot shift) postoperatively, and 94 patients (91%) had negative pivot shift results. KT-1000 arthrometric testing showed a significant reduction in manual maximum anterior translation and side-to-side differences at followup. Good range of motion was achieved. Patients with asymmetric prone heel heights usually had hyperextension in the contralateral knee. Functional tests showed 4% to 6% differences in side-to-side comparisons for a timed single-legged hop, single-legged hop for distance, and vertical jump. Postoperatively, the results of the Tegner scale were similar to preinjury scores. The mean results of the Hospital for Special Surgery scale (90), Lysholm score (89), and Noyes sport function score (90) were all excellent or good. Only 5 patients (5%) required reoperations for flexion contractures. Ninety-six patients (93%) reported they were "mostly" or "completely" satisfied, and 98 (95%) would recommend the procedure to others. These results demonstrated encouraging outcome using this single-incision technique.

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