Fr. Noyes et Sd. Barberwestin, THE TREATMENT OF ACUTE COMBINED RUPTURES OF THE ANTERIOR CRUCIATE ANDMEDIAL LIGAMENTS OF THE KNEE, American journal of sports medicine, 23(4), 1995, pp. 380-391
We performed a prospective study of 46 patients with ruptures of the a
nterior cruciate ligament and medial ligamentous structures. All patie
nts had anterior cruciate ligament allograft reconstructions. Group I
comprised 34 patients in whom all of the medial structures were ruptur
ed (parallel and oblique fibers of the superficial medial collateral l
igament and the posteromedial capsule) and were treated operatively. I
n Group II (12 patients), the superficial medial ligament fibers only
were ruptured and these were treated nonoperatively. All patients star
ted an immediate motion and rehabilitation prog ram. Forty-four patien
ts returned for followup at a mean of 5.3 years (range, 2 to 8.9) post
operatively. The results were assessed using the Cincinnati Knee Ratin
g System. At followup, 20 knees (59%) in Group I and 9 knees (73%) in
Group II had less than 3 mm of increased displacement on KT-1000 arthr
ometer testing (134 N). The overall rate of anterior cruciate ligament
graft failure was 15%:six (18%) in Group I and one (8%) in Group II.
No patient had more than 2 mm of increase on valgus stress testing at
5 degrees or 25 degrees of knee flexion. The overall ratings were as f
ollows: Group 1, 20 knees (58%) excellent or good and 14 knees (42%) f
air or poor; and Group II, 11 knees (91%) excellent or good and one kn
ee (9%) fair. Knee motion complications and patellofemoral symptoms we
re common in the patients rated fair or poor in Group I.