THE TREATMENT OF ACUTE COMBINED RUPTURES OF THE ANTERIOR CRUCIATE ANDMEDIAL LIGAMENTS OF THE KNEE

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.