A prospective, clinical study evaluating arthroscopic ACL reconstruction using the semitendinosus and iliotibial band: 2- to 5-year follow up.

Abstract

Seventy-three ACL-deficient knees were reconstructed using a modified Zarins and Rowe arthroscopic procedure utilizing the semitendinosus tendon and iliotibial band (ITB). Fifty of 73 patients returned for 2- to 5-year follow up. On follow-up visit each patient completed a questionnaire pertaining to subjective results, including level of pain and return to, activities. Physical examination included the Lachman test, anterior drawer, pivot shift, and anterior subluxation tests (using the Stryker KT 1000), each graded 0 to 3. All patients have shown a statistically significant improvement between preoperative and postoperative knee scores (P < .0001). According to the knee scoring scale, 34 patients (68%) were clinically rated as excellent, 12 (24%) as good, 4 (8%) as fair, with no poor results. All patients have returned to pre-injury jobs (or school), while most resumed some level of sporting activities. No patients complained of patella femoral symptoms postoperatively. Complications included pain over the staple which was used for fixing the ITB to the tibia, requiring removal in 5 patients. These preliminary results are encouraging, with 92% of the patients rating good to excellent. This modified procedure offers advantages over other procedures, as it is entirely arthroscopic with minimal incisions, does not damage the extensor mechanism, and permits an enhanced rehabilitation program.