Abstract
Background & Aim: Recent studies have claimed good results after ACI in athletes. Our aim was to evaluate the early functional outcome and activity level after 2-stage ACI in professional athletes and soldiers.
Methods: Thirteen soldiers and five professional athletes (14 men and 4 women; average age 31 years), with 21 full thickness cartilage defects (ICRS grade-IV) of the knee were treated with 2-stage ACI. Mean interval between injury and surgery was 43.8 months. Average defect size was 6.03 cm2 and was located to the MFC in 7 cases, LFC in 7 cases and the femoral trochlea in one case. The functional outcome was evaluated with ICRS form, Tegner activity rating scale and Lysholm score after a mean follow up period of 23.4 (18–32) months.
Results: The ICRS and Lysholm scores were improved from 42.7 and 47.6 pre-operatively to 63.1 and 69.9 respectively. The average Tegner scale was 8.8 pre-injury, 3.7 prior to surgery and 6.4 at the final follow up. Nine patients (50%) underwent second-look arthroscopy for persistent mechanical symptoms. Periosteal flap overgrowth was identified in 6 cases with adequate graft integration while partial failure of the graft was noted in one case and was treated with microfracture.
Conclusions: The early results of ACI in high-performance athletes and professional soldiers are not as good as other studies suggest. Returning to pre-injury performance levels for athletes and military people is by no means assured in the first 24 months after ACI.
Correspondence should be addressed to Mr Tim Wilton, BASK at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
