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Augmented repair and early mobilization of acute anterior cruciate ligament injuries

Department of Traumatology, Kreiskrankenhaus, Bopfingen, Germany

Jörn Deneke, MD

Department of Traumatology, Kreiskrankenhaus, Bopfingen, Germany

Laurence E. Dahners, MD

Division of Orthopaedics, University of North Carolina, Chapel Hill, North Carolina

This paper describes a technique for repair of the anterior cruciate ligament with protection of that repair by a synthetic augmentation device. Of 61 patients who underwent surgery 24 to 57 months (mean, 38.3) be fore data accumulation, 57 returned for followup. Sub jectively, 53 (93%) patients reported a good or excellent functional result; however, only 29 (51 %) of the patients returned to their preinjury sports level. Objectively, a radiographic Lachman test was performed on both the injured and the noninjured knee of all 57 patients. The preoperative mean difference between the knees was 8.6 mm (range, 4.6 to 17.2) and at followup it was 2.4 mm (range, -0.9 to 11.8). Radiographic abduction and adduction stress tests demonstrated stable healing of the (unrepaired) collateral ligament lesions (varus stress = 0.1 mm and valgus stress = 0.4 mm mean side-to- side difference), indicating that suturing of ruptured collateral ligaments is not necessary when the knee is centrally stabilized with the augmentation device. These results indicate that successful repair of the anterior cruciate ligament is frequently possible when enhanced with an augmentation device.

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