title: Repair and reconstruction of rotatory instability of the knee.
abstract: We studied the results of treatment in 110 of 129 consecutive patients who had knee instability for which they underwent reconstruction of the knee ligaments at the Mayo Clinic. Thirty-one patients underwent different types of extraarticular reconstruction. Nine (29%) had recurrence of the knee giving way, and 11 (36%) had objective signs of instability on examination. Fifty-five patients underwent combined extraarticular and intraarticular reconstruction with either the Lam-Jones patellar tendon (PT) procedure (21 knees) or the Zarins-Rowe semitendinosus and iliotibial band (ST & ITB) procedure (34 knees). Only two knees (10%) with PT procedure and three knees (9%) with ST & ITB procedures continued to have giving way. Three patients in each group had recurrence of instability. Twenty-four knees with acute instability had either primary repair (17 knees) or primary reconstruction with ST & ITB procedures (7 knees). The results in these knees were superior to the results in the knees reconstructed for chronic instability. On the basis of our 2 year results, we believe that a combined intraarticular and extraarticular reconstruction is the procedure of choice in chronic knee instability and is a useful procedure in acute knee instability with irreparable tears of the anterior cruciate ligament.
mesh_terms: D000293:Adolescent; D000328:Adult; D001178:Arthroplasty / Q000379:methods*; D001265:Athletic Injuries / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D007718:Knee Injuries / Q000601:surgery; D007719:Knee Joint / Q000601:surgery*; D008023:Ligaments, Articular / Q000293:injuries* / Q000601:surgery; D008297:Male; D012008:Recurrence; D012399:Rotation