Abstract
Objective: The treatment of Anterior Cruciate Ligament (ACL) instability resulting from incomplete tears or elongation in continuity has been historically treated either conservatively or by graft replacement. The literature is sparce with regard to alternative reparative surgical treatment of this condition. We report our early experience using a thermal shrinkage treatment on 11 consecutive knees suffering from this condition in patients experiencing continuing instability.
Methods: Eleven patients underwent ACL electrothermal monopolar treatment at our institution between 1998 and 1999. All of these patients presented a difference of 6 mm or more when comparing the involved to the uninvolved side using KT-1000 evaluation. They showed ACL incomplete tears or elongation in continuity at the time of the arthroscopic evaluation. A single electrothermal device (Oratec, Oratec Interventions, Menlo Park, CA) was used in all of the cases. Rehabilitation protocol included immobilization and non-weight-bearing for 6 weeks. A one-year minimum follow-up study was conducted in all of the patients following the IKDC rating system.
Results: The overall outcome at a one-year minimum F.U. was normal or nearly normal in all of the patients. They also showed a 30 pound side to side difference less than 5 mm. They were allowed to return to running 3 months after ACL shrinkage and to full unrestricted sports after 6 months.
Conclusions: The thermal repair of ACL-insufficient knees represents an emerging alternative treatment to standard techniques. The primary controindication for this technique is discontinuity of the ligament. Particular attention must be paid to patient compliance during ligament healing in its early stages.
The abstracts were prepared by Professor Jegan Krishnan. Correspondence should be addressed to him at the Flinders Medical Centre, Bedford Park 5047, Australia.
