SAGITTAL KNEE STABILITY AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION WITH A PATELLAR TENDON STRIP - A 2-YEAR FOLLOW-UP-STUDY

Tibial anteroposterior displacement after anterior cruciate ligament r econstruction with a patellar tendon graft was followed prospectively for 2 years in 24 patients with an arthrometer. The femoral ligament i nsertion location, in a lateral projection, and the change in intraart icular fixation distance, measured with an isometer, were documented i ntraoperatively. Two years after surgery, the overall mean injured-non injured difference in anteroposterior displacement was 2.0 +/- 2.3 mm. All grafts were fixed during surgery at 20-degrees of knee flexion. P atients for whom this angle coincided with the angle of minimum intraa rticular fixation distance (Group I), and patients who had a femoral l igament insertion location >2 mm anterior to the center of the normal anterior cruciate ligament attachment (Group A) showed larger tibial d isplacement than the other patients. An injured-noninjured difference in tibial anteroposterior displacement greater-than-or-equal-to 3 mm w as classified as failure. Groups I and A failure rates were higher tha n for the other patients. No correlation was found between anteroposte rior displacement and magnitude of the change in intraarticular fixati on distance. We conclude that anterior femoral locations lead to large r sagittal play after 2 years than central or posterior locations and that the magnitude of the fixation distance is less important than the pattern.