The late repair of torn cruciate ligaments using menisci

Abstract

An operation using either the medial or the lateral meniscus to effect the late repair of torn cruciate ligaments is described. Forty-three patients under fifty years of age who were unable to return to their work because of severe joint laxity have been treated in this way and reviewed after one to thirty years. Sagittal stability was measured by a special apparatus, and a comparison was made between normal knees and affected knees before and after operation. The review of forty-five knees showed normal stability in thirty-one, slight instability in twelve and no improvement in two. Forty-one patients had returned to their former work; twenty-two complained of instability when tired ; all had pain-free joints. The use of a meniscus for the reconstruction of either cruciate ligament is considered to be simple, safe and effective.

Optimal Replacement of the Cruciate Ligaments from the Functional-Anatomical Point of View

“…1939], '. .. at the anterior border of the medial femoral condyle ...' [Tillberg, 1977]. Sporadi cally one finds more precise data for ACL replacement ( fig.5).…”

Anterior Cruciate Ligament Reconstruction Using the Semitendinosus and Gracilis Tendons Augmented by the Losee Iliotibial Band Tenodesis

“…The pathomechanics that results from disruption of this ligament often causes instability, recurrent injury, and posttraumatic arthritis.~-~.3~47,50,56,58,66,72 Numerous methods of treatment have been advocated to restore function and normal kinematics.2 Autografts, allografts, and synthet1CS25,35,61,65 have been used in extra-and intraarticular reconstructions to stabilize the ACL-deficient knee. Autogenous extraarticular reconstructions include dynamic stabilization with pes anserinus transfer medially,68 biceps tendon transfer laterally,4 and various iliotibial band transferS.5° 12,17, 22, 37,46, 51, 54 Intraarticular procedures substitute part of the extensor mechanism,7,9,10,16,18,24,36,38,48,49,59 the iliotibial band,3o,32,55,57,67, 74 the semitendinog~g8,26,39,44,53,6o,75 and gracilis tendons,40,52,20,33,41,71,73 Intra-and extraarticular procedures have been combined to improve the efficacy of reconstruction. 1,6,9,23,28,43,62,64,76 The goals of these reconstructions are to restore stability, return the patient to the preinjury activity level, prevent recurrent injury, and minimize posttraumatic arthritis.…”

“…The pathomechanics that results from disruption of this ligament often causes instability, recurrent injury, and posttraumatic arthritis.~-~.3~47, 50 20,33,41,71,73 Intra-and extraarticular procedures have been combined to improve the efficacy of reconstruction. 1,6,9,23,28,43,62,64,76 The goals of these reconstructions are to restore stability, return the patient to the preinjury activity level, prevent recurrent injury, and minimize posttraumatic arthritis.…”

Back to the Drawing Board

“…AJSM authors of the era tested the method in an animal model 3 and compared its clinical results with patellar tendon reconstruction, 8 urging caution before widespread adoption of the technique. 3 Although reported outcomes seemed comparable to other methods of the era, 4,8,20 enthusiasm for it eventually waned as the importance of preserving the meniscus was better appreciated 4 and other, more effective alternatives were perfected.…”