title: Long-term functional results in patients with anterolateral rotatory instability treated by iliotibial band transfer.
abstract: The purpose of this paper is to define the use of the extraarticular, lateral reconstruction in the spectrum of patients with cruciate deficiency. A review was conducted of 112 consecutive patients with a MacIntosh-type iliotibial band transfer done between 1972 and 1986. Fifty-six of the patients had a partial or complete meniscectomy, and 24% had failed a previous extraarticular procedure. Eighty-one percent were men, with a mean age of 23. Twenty-five percent of the patients had radiographic degenerative changes at the knee at the outset. Ninety-eight percent had an anterior drawer of 1+ or greater; 97% had a pivot shift greater than trace. All patients had symptomatic knee instability. Seventy-seven of the 112 patients (69%) were available for followup (range, 24 months to 15.5 years; median, 7.6). Twenty-three patients (21%) returned for examination, KT-1000 and Cybex testing, and radiographs. An additional 54 patients (48%) were seen by their local physicians or returned a detailed questionnaire that included the Cincinnati knee rating scale. At final followup, 38% complained of some knee instability, 36% had recurrent effusions, 61% had intermittent pain, 79% had radiographic gonarthrosis, and 25% had undergone additional surgery. Forty-two percent had a positive Lachman after surgery, and only 15% had a pivot shift. The mean knee score was 81.1. Previous extraarticular anterior cruciate ligament reconstruction, meniscectomy, and generalized ligamentous laxity were associated with a significant decrement in the knee rating (P = 0.05). Ligamentous laxity strongly correlated with symptoms of giving way.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Division of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: T P
authors.initials: TP
authors.lastname: Vail
authors.forename: T R
authors.initials: TR
authors.lastname: Malone
authors.forename: F H
authors.initials: FH
authors.lastname: Bassett
mesh_terms: D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology* / Q000601:surgery; D007718:Knee Injuries / Q000503:physiopathology / Q000601:surgery; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013709:Tendon Transfer