Miniarthrotomy versus arthroscopic-assisted anterior cruciate ligament reconstruction with autogenous patellar tendon graft.
The purpose of this study was to determine whether two groups of patients showed any early (6 months postoperative) clinical differences when treated by arthroscopic-assisted or miniarthrotomy anterior cruciate ligament (ACL) reconstruction. Fifty-two consecutive arthroscopic-assisted ACL reconstructions (Group I) were matched with 52 miniarthrotomy ACL reconstructions (Group II). An autogenous midthird patellar tendon was used in all reconstruction procedures. Group I patients were operated on by one surgeon (A.C.R.) and all Group II patients by another (K.D.S.). Both groups were similar with regard to age, sex, injury, chronicity, and previous knee surgical procedures. All patients were treated according to the same postoperative rehabilitative protocol (emphasizing early motion, immediate full passive extension, early functional activity) and evaluated on follow-up by the same personnel and protocol. Data collection included injury and surgery dates; total surgery and tourniquet times; length of hospital stay; drain output; inpatient pain medications used; follow-up range of motion at 1.5, 2.5, and 6 weeks postoperative; KT-1000 arthrometer measurements at 10, 16, and 26 weeks; and isokinetic measurements at 10 and 16 weeks postoperative. Results indicated that follow-up range of motion and KT-1000 measurements showed no statistical difference between groups. Isokinetic average scores for quadriceps strength at 180 degrees/s showed no differences at 10 and 16 weeks. The study suggested that ACL reconstruction with midthird patellar tendon performed by skilled surgeons using either open or arthroscopic-assisted techniques combined with an aggressive postoperative rehabilitation protocol will yield similar acceptable early clinical results.