Long-term results of extensor mechanism reconstruction

A numerical rating system was designed as a method of evalu ating results of extensor mechanism reconstructions of the knee. The method was applied in evaluating the long-term results of patients treated at one orthopaedic clinic. A para mount goal was to maintain objectivity in evaluations of pa tients' knees after reconstruction. Parameters of evaluations were swelling, pain, symptoms of instability, and limitations of activity. Each factor was rated on a scale of zero to three. Results were separated into four categories (excellent, good, fair, and poor). Weighted consideration was given to each parameter in relationship to others. Forty-four females (average follow-up time, 4.80 years) and 52 males (average follow-up time, 4.72 years) were evaluated subjectively and objectively. Twenty-two patients were older than 30 years of age and 74 were younger than 30 years of age at the time of surgery. Age had no effect on an "excellent" result; patients younger than 30 years had a higher proportion in the "good" category both subjectively and objectively than those older than 30 years of age. The data show no differences in the results for men and women. The presentation of the rating system and the criteria for definitions of the terms excellent and good form the intent of this paper, not the reporting of results. As one gains expe rience in these examinations, subjectivity will be minimized. A universally applicable scale, such as presented in this design, is one way investigators may compare results obtained by any surgical technique. Furthermore, the strict criteria can be applied preoperatively and post-operatively so that the results can be placed in perspective. The numerical rating system provides a standard for evaluation of results obtained from extensor mechanism reconstructions of the knee.