SUTURING THE ANTERIOR CRUCIATE LIGAMENT - IS THIS METHOD REALLY OF ANY VALUE

After suture of the anterior cruciate ligament without anatomical augm entation, used as a routine method, 88 patients were followed up after a minimum of 2 years using the Lysholm score and the activity scale. Residual laxity was checked clinically and with the KT-1000. For compa rison, 20 patients with chronic symptomatic anterolateral instability were followed up who had been operated on using the Eriksson technique during the same time period. Postoperative treatment was a limited fu nctional approach. The peripheral ligament structures were treated fol lowing the Hughston and Muller principles. In two-thirds of the knees lateral tenodesis was added. The results of the suture method were dis appointing and inferior to the results obtained by the Eriksson techni que (trend). The Lysholm score was 77 and 82, respectively. The activi ty scale was 4.4 (recreational sports) for both groups. The Lachmann s ign (KT-1000) in side-to-side comparison (89 N) showed a residual laxi ty of 1.9 mm and 0.8 mm (average), respectively. In no series was trac topexy of demonstrable advantage. The final conclusion must be that th e suture method (with iliotibial tract tenodesis) is not superior to g uided conservative treatment. Despite an unfavorable situation preoper atively, the (abandoned) technique of ligament substitution is superio r to the suture method (trend). In isokinetic testing dominant knees f are better. In good results, a high hamstrings-quadriceps ratio is typ ical. The reasons for this are not well-trained hamstrings, but the re lative insufficiency of the quadriceps mechanism.