Anterior cruciate ligament reconstruction using quadriceps patellar tendon graft

Eighty-three patients with ACL reconstructions using the quadriceps patellar tendon graft were evaluated in a 10 year (mean, 5.5 years) follow-up study. A five-part analysis, consisting of physical examination, questionnaire, Genucom analysis, operative note review, and radiographs, was performed. Seventy-six percent were categorized as satisfactory. Ninety-two percent were content with their results, while only 4% were unsatisfied. Ninety-three percent of the patients had no significant pain and 95% had no giving way postreconstruction. Ninety-two percent had no more than a mild functional deficit. Eighty-seven percent and 90% of the patients had no significant Lachman or pivot shift by examination, respectively. Our results showed no increase in failure over time (1 to 10 years), although those operated on during the initial 5 years showed more radiographic degenerative changes. Plotting our results in classification systems of other authors yielded success rates as good as or better than those using our own criteria. An objective means by which to quantify laxity did not reliably correlate with the quantifying of laxity made by physical examination. Only the lack of a formal rehabilitation program greater than 4 months postoperatively and repaired tears of the medial or lateral collateral ligaments proved to be significant risk factors for poor recovery.