Poster 325: Untreated Ruptures of the Anterior Cruciate Ligament: a 54 Year Follow-Up Study

Objectives: Anterior cruciate ligament (ACL) ruptures are associated with instability, meniscus injuries, difficulties sports, and ultimately post-traumatic osteoarthritis. End stage knee arthritis is often treated total arthroplasty (TKA). To assess the effectiveness of any treatment for ACL natural history ACL-deficient must be considered. The objective this longitudinal study to establish a baseline by tracking subjective outcomes knees over 54 years. Results analyzed in light 6 previous iterations knee. Methods: This sixth iteration retrospectively established cohort 50 patients whose isolated were surgically verified between 1960 1974 but left unreconstructed. When was established, 3 had bilateral knees; thus, there 53 studied original cohort. None included other ligamentous injuries at index arthrotomy. Knees meniscal not excluded from study. Meniscus complete medial and/or lateral meniscectomy, as standard time. has been evaluated via questionnaires, radiographs, examinations 10, 14, 19, 29, 44, currently years since injury. Marshall, Lysholm, Fairbanks scores used objectively stability, functionality, radiographic changes, respectively. same questionnaire, only minor updates, each gather information regarding exercise habits, activity levels, symptoms, pertinent information. Results: All accounted for—no member 1975 permanently lost follow-up. 5 due unrelated disability or illness. At final follow-up, 32 48 (66.7%) native. Of these, 15 still living reevaluated. remaining 16 (33.3%) undergone TKA. mean age injury 18.3 (standard deviation 6.72). time elapsed arthrotomy 7.56 months 7.05 years). arthrotomy, 31 (64.6%) underwent 4 (8.33%) 1 (2.08%) both 9 (18.8%) did undergo either meniscectomy. In interim surgery 20 (41.7%) additional surgery. 2 these multiple late surgeries; required articular cartilage repairs; ACL- reconstructions; eventually an tumor excision. 7 meniscectomy that require TKA, which 27 (56.3%) (25.9%) (50.0%) 12 (25.0%) meniscectomies Notably arthrotomy; individual (10.4%) point. (20.0%) without TKA; 11 (36.4 %) An (60.0%) Thus, known damage, (43.8%) began, deficiency. Since then, more ruptured their contralateral ACL. Though entered into study, documented ACL-deficiency replaced 29- 44-year (14.6%) 44- 54- year TKA 58.7 years, 41.0 after median Marshall score 37 10-year 38 14-year 36 41 54-year native living. reassessed. 69.3. described patient excellent, good, fair, poor. caused no pain, mild moderate 0 severe pain. received injections last 10 took prescription anti-inflammatories pain medications. reported hinders activities daily interfere sports. prevented 8 longer play examined radiographed. grossly stable. showed evidence Conclusions: leads While 33.3% 66.7% have coped relatively well through adulthood. our knowledge, first track