For the past 5 years we have attempted to correct knee instability due to rupture of the posterior cruciate ligament with a procedure that employs a free graft of one-third of the patellar tendon with its tibial and patellar attachments. This procedure was done for chronic instability in 33 patients and was combined with primary repair of an acute mid-substance tear of the posterior cruciate ligament in 15 patients. Moderate to severe articular injury of the medial femoral condyle was found at operation in 48 per cent of the patients with chronic injury. 71 per cent of the patients for whom the interval between injury and ligament reconstruction was 2 to 4 years, and 90 per cent of those for whom the interval was more than 4 years, showed articular injury of the medial femoral condyle. Only 31 per cent of the patients, however, had preoperative radiographic findings that indicated femoral articular damage. 23 of the 25 patients with a minimum follow-up of 2 years returned for evaluation. All of the 10 patients who had had a repair and reconstruction of an acute ligament injury (whose average follow-up was 41 months) had a static and functional result that was graded as good or excellent. Of the 13 patients for whom surgery was done for chronic instability (whose average follow-up was 31 months), the over-all static and functional result was graded as good or excellent in 11. These results indicate that the use of one-third of the patellar tendon for reconstruction in patients with acute mid-substance tears as well as in patients with symptomatic chronic instability of the posterior cruciate ligament is an effective procedure for achieving static and functional stability of the knee.
Copyright remains with the authors and publisher.
For the past 5 years we have attempted to correct knee instability due to rupture of the posterior cruciate ligament with a procedure that employs a free graft of one-third of the patellar tendon with its tibial and patellar attachments. This procedure was done for chronic instability in 33 patients and was combined with primary repair of an acute mid-substance tear of the posterior cruciate ligament in 15 patients. Moderate to severe articular injury of the medial femoral condyle was found at operation in 48 per cent of the patients with chronic injury. 71 per cent of the patients for whom the interval between injury and ligament reconstruction was 2 to 4 years, and 90 per cent of those for whom the interval was more than 4 years, showed articular injury of the medial femoral condyle. Only 31 per cent of the patients, however, had preoperative radiographic findings that indicated femoral articular damage. 23 of the 25 patients with a minimum follow-up of 2 years returned for evaluation. All of the 10 patients who had had a repair and reconstruction of an acute ligament injury (whose average follow-up was 41 months) had a static and functional result that was graded as good or excellent. Of the 13 patients for whom surgery was done for chronic instability (whose average follow-up was 31 months), the over-all static and functional result was graded as good or excellent in 11. These results indicate that the use of one-third of the patellar tendon for reconstruction in patients with acute mid-substance tears as well as in patients with symptomatic chronic instability of the posterior cruciate ligament is an effective procedure for achieving static and functional stability of the knee.
Copyright remains with the authors and publisher.