ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING THE SEMITENDINOSUS AND GRACILIS TENDONS AUGMENTED BY THE LOSEE ILIOTIBIAL BAND TENODESIS - A LONG-TERM STUDY

Seventy patients were evaluated after combined intra-and extraarticula r reconstruction of the anterior cruciate ligament. Semitendinosus and gracilis tendons were used for the intraarticular reconstruction and Losee iliotibial band tenodesis for the extraarticular procedure. Mini mum followup was 5 years (average, 7). Clinical examination and instru mented ligament examination with the KT-1000 arthrometer and the Cybex II dynamometer were used to evaluate results. Subjectively, patients had no complaints of instability with daily activities; 93% had no com plaints of instability with athletic participation. Clinical examinati on demonstrated that 81% had less than a 1 + Lachman test; 98% had a n egative pivot shift. Instrumented examination of the anteroposterior l imits of motion revealed that only 57% had less than 3-mm side-to-side difference; 30% had 3- to 5-mm; and 13% had 6- to 9-mm. Mean hamstrin g muscle strength measured with the Cybex II dynamometer was 94% at 60 and 96% at 100 deg/sec. When evaluated with the Zarins scale, 90% wer e rated good or excellent, 6% fair, and 4% poor. This reconstructive. procedure restores functional, but not necessarily normal, stability i n most anterior cruciate ligament-deficient knees. It allows patients to increase activity levels without significant risk of additional inj uries.