Long-Term Follow-Up of 24.5 Years After Intra-Articular Anterior Cruciate Ligament Reconstruction With Lateral Extra-Articular Augmentation

Background: Many studies have reported successful outcomes 10 to 15 years after ACL reconstruction. However, few authors report results at ultra long-term follow-up (more than 20 years of follow-up). Purpose: The aim of this study was to determine how the status of the medial meniscus and the medial compartment articular cartilage observed at the time of ACL reconstruction affects results more than 24 years after surgery. This article examines long-term outcome of ACL reconstruction with extra-articular augmentation (procedure performed through a medial arthrotomy). Study Design: Case series; Level of evidence, 4. Methods: One hundred of 148 patients reviewed at 11.5 years of follow-up could be reviewed at 24.5 years. Complete clinical and radiographic evaluation (International Knee Documentation Committee scale and Knee Injury and Osteoarthritis Outcome Score) was performed. Results: The radiographic International Knee Documentation Committee rating was as follows: grade A, 39%; grade B, 7%; grade C, 27%; and grade D, 27%. Onset of osteoarthritis was correlated with medial meniscal status and femoral chondral defects at time of surgery. Conclusion: Total medial meniscectomy and articular cartilage damage were risk factors for osteoarthritis.