THE DACRON LIGAMENT PROSTHESIS IN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION - A 4-YEAR REVIEW

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.