Reconstrucción del ligamento anterior cruzado y riesgo de lesión de rodilla. (I)

"Efecto de la reconstrucción del ligamento anterior cruzado en el riesgo de nueva lesión de rodilla."

Junji Ide, MD, PhD*, Satoshi Maeda, MD and Katsumasa Takagi, MD, PhD

From the Department of Orthopaedic Surgery, Kumamoto University Hospital, Department of Orthopaedic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Kumamoto University

Purpose:
The purpose of this study was to evaluate the results in selected high-risk patients who underwent arthroscopic stabilization of shoulders with recurrent anterior instability.

Hypothesis:
Arthroscopic stabilization using suture anchors is useful for athletes younger than 25 years or for contact athletes without a large bone loss of glenohumeral articulation.

Study Design:
Prospective cohort study.

Methods:
The study group comprised 55 patients, with a mean follow-up of 42 months (range, 25–72 months). Thirty-two patients had recurrent dislocations, 14 had recurrent subluxations, and 9 had recurrent subluxations after a single dislocation. Rowe score, range of motion, recurrence, and sports activities were evaluated.

Results:
Mean Rowe score improved from 30.1 to 92.3 points; 45 scores (82%) were excellent, 5 (9%) good, 1 fair (2%), and 4 (7%) poor. Patients had lost a mean of 4° of external rotation in adduction. Four (7%) had recurrence. The recurrence rate in contact athletes (9.5%, 2 of 21) was not statistically different from that in noncontact athletes (6%, 2 of 34). Forty-four (80%) returned at the same levels. The complete return rate in overhead-throwing athletes (68%, 17 of 25) was lower than that in nonoverhead athletes (90%, 27 of 30) (P = .0423). Five patients had unsatisfactory results.

Conclusion:
Arthroscopic stabilization is a reliable procedure in selected high-risk patients.

The American Journal of Sports Medicine 32:1899-1905 (2004).