A Minimum 2-year Follow-up After Selective Anteromedial or Posterolateral Bundle Anterior Cruciate Ligament Reconstruction

Purpose: The purpose of this study was to investigate the 2-year follow-up clinical results of 45 patients who had undergone our anterior cruciate ligament (ACL) augmentation procedure using an autogenous semitendinosus tendon and the EndoButton CL (Smith & Nephew, Andover, MA).

Methods: We followed up 45 patients for more than 2 years after their ACL augmentations. Of these, 37 were anteromedial (AM) bundle reconstructions and 8 were posterolateral (PL) bundle reconstructions. They were assessed using a KT-2000 knee arthrometer (MEDmetric, San Diego, CA) at 30 lb by joint position sense, Lysholm knee score, and magnetic resonance imaging (MRI).

Results: The mean side-to-side difference of anterior displacement measured by the KT-2000 knee arthrometer at 30 degrees of knee flexion preoperatively was 3.3 +/- 2.4 mm, significantly improving to a mean of 0.5 +/- 2.7 mm 2 years after surgery. The preoperative joint position sense inaccuracy was 1.6 degrees +/- 1.8 degrees , which improved significantly to 0.3 degrees +/- 2.0 degrees after surgery. The median Lysholm knee score significantly improved from 74 (range, 44 to 95) to 100 points (range, 81 to 100) after surgery. In 20 of 29 patients who had the postoperative MRI examination, the augmented ACL resembled 1 bundle on the sagittal planes of the postoperative MRI.

Conclusions: Selective AM or PL bundle reconstruction showed improved joint stability, joint position sense, and Lysholm scores postoperatively. This procedure can be a treatment option for patients whose ACL remnants are left in certain conditions.