Gore-Tex prosthetic ligament in anterior cruciate deficient knees.
Reconstruction for symptomatic anterior cruciate deficient knees has yielded varying success rates. Prosthetic cruciate replacement has recently become a potentially attractive alternative. The results of the Gore-Tex polytetrafluoroethylene ligament, which is intended as a permanent replacement, are reported. Eighty-two patients were followed prospectively, mean age was 28 years (range, 16 to 51 years) and mean followup was 18 months (range, 12 to 30 months). Subjective scores improved in all categories, including pain, swelling, giving way, locking, and stair climbing. All patients without complications had no episodes of actual giving way, considered themselves improved, and returned to activities of daily living at 3 weeks and athletics at 8 months. Range of motion lacking at 3 months was 2 degrees of extension and 10 degrees of flexion, and at 12 months was 0 degrees of extension and 4 degrees of flexion. All mean objective data, including the anterior drawer, Lachman, and pivot shift, demonstrated improvement at final followup. Cybex testing revealed improvement in relative quadriceps strength from 88% to 99%. The KT-1000 Arthrometer showed improvement in the injured-normal knee difference score throughout the follow-up period. Of importance is that while final objective data was improved over initial data, an early nonprogressive shift toward loosening was indicated by worsening of the drawer, Lachman, pivot shift, and KT-1000 scores. This shift may be attributed to resorption of interposed soft tissue, creep, or loosening of the graft. Subjective scores remained stable after improving. Complications included four ruptures, four chronic sterile effusions with partial attenuation, one infection, and one symptomatic loose body.(ABSTRACT TRUNCATED AT 250 WORDS)
Glousman
R
R
Kerlan-Jobe Orthopaedic Clinic, Inglewood, California.
Shields
C
C
Kerlan
R
R
Jobe
F
F
Lombardo
S
S
Yocum
L
L
Tibone
J
J
Gambardella
R
R
D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D001265:Athletic Injuries / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000503:physiopathology / Q000601:surgery*; D008023:Ligaments, Articular / Q000293:injuries* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011446:Prospective Studies; D019736:Prostheses and Implants; D013177:Sports
D011138:Polytetrafluoroethylene