Early results of double anterior cruciate ligament prosthetic reconstruction

ABSTRACT

The technique described gives a new approach to the repair of ACL tears. The study reports the early results and analyses the experience gained. 21 males, aged 22-36, mean 28.5 years, managed in Madina National Hospital, Maidina, Saudi Arabia, 1988-1991, They suffered from chronic ACL instability for 1-6, mean 2.4 years, caused by complete ACL tears, in the left knee in 14 cases [66.7%], and in the right in 7 eases [33.3%]. The accidents in which the tears were sustained occurred during sports [5 cases = 23.8%] or work circumstances [16 = 76.2%]. As-sedated knee injuries were tears of the medial collateral ligament in all cases, and of the medial meniscus in 13 cases [61.9%]. In the operative procedure the two bands of the torn ACL were reconstructed by a double technique using two segments of the Leeds-Keio ligament prosthesis. The posterolateral segment was passed over the top of the lateral femoral condyle. The anteromedial segment was passed through a tunnel in the lateral femoral condyle. The postoperative care was nearly that of Fujikawa. It included gradual intermittent passive motion apparatus and gradual weight bearing over a period of 14 weeks. The followup was 25 - 52, mean 38.3 months. The anterior drawer test preoperative mean value was 2.5, SEM +/- 0.59 and postoperatively it was 0.5, SEM +/- 0.51, t = 2.56, P surgery it became and remained poor in 2 cases [9.5%], good in 10 patients [47.6%] and excellent in 9 [42.9%]. Those who resumed their pre-injury activities were 19 cases [90.5%]. The mean loss of knee movements was 3.8°. The association with tears of the meniscus or of medial collateral ligament had no appreciable effect on the results. It is concluded that the early results of the described procedure are promising and encouraging