Arthroscopic Anterior Cruciate Ligament Replacement Using a Bone - Tendon - Bone Autograft – A Prospective 5 Year Follow - Up Study

Purpose: To investigate the outcomes of an open and an arthroscopic technique for the reconstruction of the Anterior Cruciate Ligament (ACL). Methods: This prospective randomized controlled trial includes 126 patients. 65 were assigned to an open ACL replacement and 61 to an arthroscopic ACL replacement, always using Bone-patellar tendon-bone (BPTB) autografts. Outcome assessment included rerupture findings, International Knee Documentation Committee (IKDC) and Lysholm-Tegner scores, KT-1000 arthrometer measurements, Lachman, single-leg hopand pivot-shift tests as well as range of motion (ROM) control. Results: In the time between April 2008 and May2010 we prospectively evaluated 62 patients using this open approach and 49 patients using an arthroscopic technique. Patients of the “open” group improved the IKDC score for 46.3 points comparing preoperative values with the 5 year follow-up. After 3 years and more there is no statistical difference between both groups when comparing IKDC score and Lysholm score. In addition, Ligament laxity demonstrated to be almost equal over the complete follow-up period. Conclusion: Although minimal invasive open techniques seem to be widely buried in oblivion and unfashionable in an arthroscopic dominated scientific discourse, they may have equivalent clinical long term results and can therefore be considered as a solid treatment option.