Reconstruction of the anterior cruciate ligament. A new positioning and fixation technique.
A new technique for ACL reconstruction is presented. The middle third of the patellar tendon is anchored to the inner surface of the lateral femoral condyle under direct visual control. The transplant is fixed tibially beneath a bone block removed from the ventral tibial head. Thirty-three patients were evaluated preoperatively and 27 months (range, 24 to 30 months) postoperatively. The mean preoperative function score (Lysholm scoring scale) was 72 +/- 14 points; the mean postoperative score was 84 +/- 13 points. The Lachman test was positive for all patients preoperatively, but the test results in the postoperative follow-up examination were negative--1+ in 31 knees and 2+ in 2 knees. All 33 knees elicited a definite "hard" end point. The postoperative KT-1000 measurement for anterior tibial displacement showed no significant difference between the operated versus the unoperated knee. Before their knee injury all patients had been engaged in sports. At the follow-up examination, 13 patients had made a full return to their former sports activities, 13 were restricted in their sports activities, and 7 patients no longer participated in sports.