Gr. Barrett et al., THE DACRON LIGAMENT PROSTHESIS IN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION - A 4-YEAR REVIEW, American journal of sports medicine, 21(3), 1993, pp. 367-373
We studied 40 patients who underwent reconstruction for chronic anteri
or cruciate ligament deficiency with a Dacron ligament prosthesis usin
g a modified MacIntosh over-the-top technique, augmented with iliotibi
al band. Thirty patients had undergone at least 1 prior surgical proce
dure on the affected knee, but only 7 patients had previous anterior c
ruciate ligament reconstruction. All patients were followed for a mean
of 47.5 months. The results at final followup demonstrated an average
side-to-side arthrometer difference of 1.0 mm. The Lysholm score impr
oved from 65 preoperatively to 89 at the end of the review; the Tegner
activity level score improved from 3 to 5. Objectively, 75% of the pa
tients had a negative Lachman test result and 95.1% of the subjects ha
d negative or trace pivot shift results at review. Mild knee pain was
still present with day-to-day activity in 87.7% of the patients. Compl
ications occurred in 27.5% of patients, including five who had implant
ruptures and two who had their grafts removed. Synovitis was a signif
icant problem. Based on our failure criteria, 47.5% (19) of the subjec
ts had failed results. In this study, radiologic evidence of tracer se
paration greater than 1 cm was a criterion of failure. With inclusion
of tracer separation, the failure rate increased to 60.0% (24). Multip
le previous surgeries of any type had an adverse effect on results. Da
mage to secondary stabilizers in these cases increased failure rate. B
ased on the high complication and failure rates, and relatively poor e
nd result in this retrospective review, we cannot recommend this proce
dure.