[The plastic replacement of old ruptured cruciate ligaments. II. Late results (author's transl)].
We discuss the results of postoperative examinations of 66 patients, who were treated at the Orthopaedic Hospital of the University of Munich by different methods of ligament grafts for old ruptures of the cruciate ligaments. Distally attached tendons of the pes anserinus group as replacement material show better results than distally attached medial thirds of the patella tendon. Biomechanical reasons are discussed, which have led to the changing of this method by using the medial one third of the patella ligament as a free graft. Advantages and disadvantages of fascia lata and the meniscus as a cruciate graft are discussed, a final judgement of the long term results is impossible with their small number of cases. In total an agreable subjective result was achieved in two thirds of the cases (60.6 per cent), an objective result from "very good" to "agreable" in more than three quarters of all cases (86.4 percent) be reparative procedures at the crucitate ligaments. Tightening or grafting of the collateral ligaments are discussed for its influence on the result of the cruciate graft. It is found, that with insufficient lateral stabilisation of the joint an eventually remaining anterior-posterior instability is increased as a rotatory instability. Finally it can be said, that only the repair of the loose posterior capsule in all ligament grafting procedures can lead to a final stabilisation of the knee joint.
D000328:Adult; D001696:Biomechanical Phenomena; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery*; D008023:Ligaments, Articular / Q000293:injuries*; D008297:Male; D008722:Methods; D012399:Rotation; D012421:Rupture; D013997:Time Factors
Der plastische Ersatz veralteter Kreuzbandrupturen. II. Spätergebnisse