Secondary reconstruction of the anterior cruciate ligament (ACL) in competitive athletes.

A follow-up study of 325 patients with surgical repair of ligamentous lesions from 1971 to 1977 demonstrated 88% good results in a group treated by one operation. Only 66% of patients who had had two or more operations had good results. High-performance athletes may regain a reasonably good level of function if knee joint instability is limited to anterior cruciate ligament instability. Superimposed injury causing rotatory instability significantly reduces the incidence of good recovery of function even if repaired by the best known surgical procedures. Function sufficient for noncontact, nonviolent sports is often possible. A poor prognosis for long-term joint function is attributable to chondromalacia and accompanying proliferative synovitis. The earlier a ligamentous lesion is repaired, the better the prognosis.