Lateral Extra-Articular Knee Reconstruction: Long-Term Patient Outcome and Satisfaction

ABSTRACT: Fifty-two patients who had an extraarticular reconstruction for anterior cruciate  ligament (ACL) insufficiency were interviewed at an average of 11.4 years after their  reconstruction. During the follow-up period, 4 patients (8%) had intra-articular  reconstructions for persistent instability or re-injury, and another 4 (8%) had arthroscopic surgery for meniscal lesions. The mean Lysholm score at follow-up was 76.9. Of the 52 patients, 5 had had subsequent surgery during the follow-up period. In the remaining 47  patients, the results were excellent in 14 (29%), good in 10 (23%), fair in 7 (15%), and poor in  16 (33%). Patients operated on acutely (<6 weeks after injury) had a mean score of 82, whereas  patients operated on more than 6 weeks after injury had a mean score of 75. Adding those patients who required subsequent reconstructions for persistent instability (4 knees) and  those who obtained fair and poor results yielded an alarming rate of unsatisfactory results  52%). On the basis of these findings, we believe the lateral extraarticular reconstruction is not an acceptable form of treatment for the functionally unstable knee.