Eighteen- to twenty-four-year follow-up after complete rupture of the anterior cruciate ligament

A unilateral, complete rupture of the anterior cruciate ligament was diagnosed in 60 consecutive patients by arthroscopy within 1 week of trauma. Most ruptured ligaments were treated by acute nonaugmented repair immediately after the arthroscopy. Fifty-five and 56 patients were reevaluated after 12 years and 20 years, respectively. Twenty-five patients (45%) had at least one reoperation during the follow-up period of 20 years, primarily for meniscal problems. Seven patients (13%) had repeat anterior cruciate ligament surgery. The overall Lysholm knee function score remained at a median of 90 points from 12 to 20 years, but patients had decreased their sporting activities from team sports at full rehabilitation to physical fitness activities at the late follow-up. Patients who had repeat surgery had a worse knee function score, were less satisfied with their knees, and also had to change activities and change work more often than patients without reoperation. The majority of patients had, at both follow-up periods, unstable knees. At 20 years, weightbearing radiographs showed slight-to-moderate changes equivalent to osteoarthrosis in 84% (47) of patients and a 32% increase in osteoarthrosis since the 12-year evaluation.