The anterior cruciate ligament: radiographic and clinical signs of successful and unsuccessful repairs.

Our ten-year observation of anterior cruciate ligament injuries in an active athlete population shows that radiographic evidence of instability and joint deterioration are reliable clinical signs. Radiographic findings in the rotatory unstable knee are subtle six months after injury, but on standard roentgenographic views, which include the notch view, they appear in a sequential order from peaking of the intercondylar tubercles to buttressing osteophytosis. These are objective signs of progressive deterioration that should be a warning to the patient. The early and progressive radiographic signs portend further deterioration if stability is not obtained by restriction of activities, bracing, or reconstruction. Physicians and sports injury specialists should recognize these findings early and offer counsel to the patient at risk.