Isolated tear of the anterior cruciate ligament : five-year follow-up study

The opinions and assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense. This paper was presented and discussed at the Annual Meeting of the American Orthopaedic Society of Sports Medicine, New Orleans, Louisiana, July 23. 1975.Reprint requests may be addressed to the Technical Publications Editor, Letterman Army Medial Center, Presidio of San Francisco, California 94129.Reprinted from The American Journal of Sports Medicine 4:95-100. 1976.During the period 1967 to 1971, 64 cadets at the United States Military Academy, West Point, New York, had surgical repair for isolated tear of the anterior cruciate ligament. In a five-year follow-up study to determine the functional impairment, present disability, and reinjury to the knee, 32 of the 64 patients were located and evaluated by radiographic examination and either by interview or by questionnaire. Twenty-two were commissioned to full duty, 23 had attended ranger or airborne school, and 16 had been in combat. Impairment of ordinary activities was noted by 12 and impairment of athletic endeavors by 24; pain by 71%; swelling by 66%; stiffness by 71%; and instability by 94%. Seventeen of the 32 had experienced a significant reinjury after the repair of the anterior cruciate ligament. Clinically, the isolated tear of the anterior cruciate ligament can be diagnosed by four essential ingredients-a pop at time of injury, inability to continue participation, gross swelling of knee, and maximal swelling within 12 hr. The mechanism of injury is usually deceleration and change of direction, not contact with another player. The follow-up study on this small series indicates that the patients have progressive deterioration of the knee. J Orthop Sports Phys Ther 1990;12(6):232-236.