Good mid-term results of repair of anterior cruciate ligament tears combined with fixation of Segond fracture in active patients: a two-year prospective study

BACKGROUND: Anterior cruciate ligament (ACL) tears may lead to knee instability and higher risk of early post-traumatic arthritis. Combined lesion of ACL and one of the secondary restraints leads to anterolateral rotation instability. The purpose is to report the early clinical outcomes of a series of ten consecutive patients who sustained acute ACL tears associated with a Segond fracture (SF) and underwent arthroscopic primary repair of ACL and SF fixation within 14 days from injury.METHODS: Preoperative evaluation included history and physical examination, plain radiography, and a 1.5-T MRI. The patients were prospectively followed post-operatively, evaluating the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Tegner Lysholm Knee Scoring Scale (TLKSS), and both subjective and objective International Knee Documentation Committee (IKDC) scores. MRI was also performed post-operatively at 12 months. Failure rate and complications were evaluated.RESULTS: At final follow-up, the mean postoperative KOOS score was 96.6 (SD: 1.6), and the mean IKDC score was 94.4 (SD: 4). The MRI showed normal morphology of the repaired ACL at the first post-operative month; the MRI signal intensity was graded isointense at three- and six-months follow-up in all patients. There were no reported complications.CONCLUSIONS: ACL repair is an option in the surgical management of primary ACL tears in properly selected patients. Acute ACL repair combined with SF fixation shows good clinical and MRI outcomes at 2-year follow-up. The combined treatment of these lesions should be taken into consideration in such patient.