[Recent ruptures of the anterior cruciate ligament. Suture technique on a reinforcement ligament. Results of a 5 years' experience].
225 patients with acute rupture of the anterior cruciate ligament were operated upon with a knitted polyester synthetic ligament (Ligastic) reinforced by a suture of the anterior cruciate ligament remnant. Five technical points must respected during the implantation of the ligament: isometry, direction of the femoral and tibial tunnels, absence of abrasion of the ligament in the notch, tensioning of the synthetic ligament equal to the natural cruciate ligament, careful suture of the remnants of the ruptured anterior cruciate around the synthetic ligament replacement. The functional results, according to the rating system of ARPEGE, demonstrated 8.6 on the stability scale, 8.1 for pain, 8.7 for mobility; 87 per cent of the competitors were able to return to their sport at the same level. There were no cases of acute synovitis. The patients were separated into three groups for evaluation: Group I--More than three years follow-up. Group II--More than two years follow-up. Group III--Less than two years follow-up. An anterior drawer test of less than 5 mm was observed in 85 per cent of Group I, 88 per cent of Group II, and 87 per cent of Group III. A negative jerk test was noted in 92 per cent of Group I, 95 per cent of Group II and 95 per cent of Group III. These differences were not statistically significant. On follow-up, a Lachman test of less than 5 mm was found respectively in 37 per cent, 70 per cent and 79 per cent; this difference was statistically significant. The relatively mediocre results of the Lachman test in Group I led us to follow a more precise isometric method. Postoperative cases were reexamined and demonstrated that the artificial ligament had become covered with an oriented fibrous tissue. The long-term outlook also depended on a successful restoration of proprioception in the repaired remnant of the anterior cruciate.
Laboureau
J P
JP
Centre Orthopédique et traumatologique, Chenove.
Cazenave
A
A
D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D001182:Arthroscopy; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D007720:Knee Prosthesis; D011091:Polyesters; D012189:Retrospective Studies; D012421:Rupture; D013536:Suture Techniques; D013997:Time Factors
D011091:Polyesters
Ruptures récentes du ligament croisé antérieur. Technique de suture sur ligament de renfort. Résultats après cinq ans d'expérience.