Background: Anterior knee instability associated with rupture of anterior cruciate ligament (ACL) is a disabling clinical problem in general and especially in athletic individuals. ACL has a poor capacity of healing. The need for surgical correction of ACL injuries arises because, untreated complete injury to the ligament leads to progressive symptomatic instability leading to recurrent injury and damage to the menisci and articular cartilage thus resulting in early osteoarthritis. The bone-patellar tendon-bone auto graft has been widely accepted as the gold standard for ACL reconstruction with a high success rate.
Aim: To study the functional outcome of ACL reconstruction using BPTB graft, various advantages and complications following ACL reconstruction using BPTB graft.
Methods: The present study was carried out at Department of orthopaedics, Navodaya Medical College and Hospital, Raichur. It is a Descriptive observational study. All patients (30) with diagnosis of ACL tear are included during the period of September 2017 to August 2019.
Results: Majority of the patients i.e. 12 (40%) were from 15-25 years age group Male predominance was found in our study. 24 (80%) patients were males and 1 (20%) patient were females. Male to female ratio was 4:1.Right knee involvement was seen in 18 patients i.e. 60% and left sided knee involvement was seen in 12 (40%). In majority of the patients i.e 15 (50%), sports was the commonest mode of injury. Knee pain was commonest symptom in 15 i.e. 50% patients. Instability was complained by 9 (30%), knee pain with instability by 4 (13.3%) and locking by 2 (6.7%). Mean score at 3 months was 80.2±12.3. At 6 months was 85.3±9.2. At 1 year was 91.1±8.7. At 18 months was 94.2±8.1 and at 2 years it was 95.8±7.1. When we compared the mean XIV score at different follow up periods, it was found to be statistically significant (p<0.05). Outcome evaluation after surgery was assessed by using Lysholm & Gillquist Knee Scoring Scale. The result was found to be good in 14 i.e. 46.7%, excellent in 12 i.e. 40% and fair in 4 i.e. 13.3% patients. Results of Anterior Drawer test at 3 months was negative in 27 i.e. 90% patients and 1+ in 3 i.e. 10% patients, at 6 months was negative in 29 i.e. 96.7% patients and 1 + in 1 i.e. 3.3% patients. Results of Anterior Drawer test at one year was negative in 29 i.e. 96.7% patients and 1+ in 1 i.e. 3.3% patients. In 29(96.7%) of patients, there was no decrease in range of movement whereas in 1(3.3%) the movement was restricted at ≥ 20 degree at the end of 1 years follow up. Prevalence of complications was reported as 23.3% in our study. In 4 patients i.e. 13.3% anterior knee pain was commonly observed complication. Superficial infection, deep infection and extensor leg was seen in 1 patient each i.e. 3.3%.
Conclusions: Most commonly affected age group was 15-25 years with male preponderance. Commonest cause of ACL tear was sports injury. In 86.7% cases, good to excellent result was observed. Prevalence of complications was reported as 23.3%.