Arthroscopic BPTB graft reconstruction in ACL ruptures: 15-year results and survival.

PURPOSE: The aim of this study is to investigate the 15-year results and survival of arthroscopic ACL reconstruction using the central-third patellar bone-tendon-bone (BPTB) autograft.

METHODS

ACL BPTB reconstruction was performed in 250 consecutive patients. Of these patients, 88% returned for a follow-up examination at 15 years after reconstruction. Therefore, 220 patients were studied. Mean time from injury to intervention was 3.4months (range 2 to 16). The parameters for assessment of results were subjective satisfaction, clinical examination (pivot-shift test, Lachman test with KT-1000), recovery of pre-injury activity level, and long-leg standing radiographs. We also evaluated the presence of meniscal and/or chondral injuries during the procedure. Failure rates were also evaluated. We defined a failure as severe instability not compatible with the activities of daily living (ADL) due to graft rupture.

RESULTS

8.2% of patients required a revision procedure because of graft rupture. In subjective terms, 98.1% of patients said that they were satisfied with the surgical outcomes after 15 years. Pivot shift test was normal in 93.5% at 15 years. Lachman test (KT-1000) was normal in 95.4% at 15 years. Fifteen years after surgery, 90% of patients recovered their pre-injury activity level. In 25.4% of patients symptomatic osteoarthritic changes in the knee were found at 15 years.

CONCLUSIONS

The survival prevalence of arthroscopic ACL reconstruction using the central-third patellar bone-tendon-bone (BPTB) autograft at 15 years was 94.8%. Fifteen years after surgery, 90% of patients recovered their pre-injury activity level. In 25.4% of patients symptomatic osteoarthritic changes in the knee were found at 15 years.

LEVEL OF EVIDENCE: Level IV.