ARTHROSCOPICALLY ASSISTED SEMITENDINOSUS AND GRACILIS TENDON GRAFT INRECONSTRUCTION FOR ACUTE ANTERIOR CRUCIATE LIGAMENT INJURIES IN ATHLETES

We evaluated 69 arthroscopically assisted anterior cruciate ligament r econstructions for acute tears at an average followup of 60 months, We used a distally based single semitendinosus and gracilis tendon graft passed over the top and fixed to the femur. Combined medial collatera l ligament lesions were seen in 30 knees, and they were repaired when found in the distal third (18 knees). The patients were instructed to recover motion preoperatively, and an early range of motion program wa s used postoperatively. At followup, symptoms of giving way were seen in five knees (7%). Craft failure was seen in seven knees (10%), failu re was defined as a positive pivot shift (clunk or gross) or a side-to -side difference in anterior tibial displacement greater than 5 mm, as measured with a KT-1000 arthrometer. Permanent extension loss (3 degr ees to 5 degrees) was found in two knees (3%). Patellofemoral crepitat ion was seen in eight knees (12%), but the condition was symptomatic i n only one knee. Forty-six patients (67%) were active in pivoting spor ts before surgery and 37 (54%) remained active in these sports at foll owup. We concluded that this operation is simple, effective, and has a low complication rate, Further studies are necessary to elucidate if a stronger graft (e.g., a. patellar tendon) would decrease the rate of graft failure without increasing complications.