RECONSTRUCTION OF THE LATERAL COLLATERAL LIGAMENT OF THE KNEE WITH PATELLAR TENDON ALLOGRAFT - REPORT OF A NEW TECHNIQUE IN COMBINED LIGAMENT INJURIES

This is a retrospective study of 10 patients with combined cruciate li gament and posterolateral instability who underwent surgical reconstru ction between 1991 and 1994. All knees had at least 20 degrees increas ed external rotation at 30 degrees of knee flexion and from 1+ to 3+ v arus instability. Five knees with posterior cruciate ligament ruptures had at least a 2+ Lachman test result. (One knee had both anterior an d posterior cruciate ligament injuries.) In all cases the lateral coll ateral ligament was reconstructed with a bone-patellar tendon-bone all ograft secured with interference screws. Fixation tunnels were placed in the fibular head and at the isometric point on the femur. The cruci ate ligaments were reconstructed with autograft or allograft material. The average follow-up was 28 months. Excessive external rotation at 3 0 degrees of flexion was corrected in all but one knee. Six patients h ad no varus laxity, and four patients had 1+ varus laxity at 30 degree s of flexion. The posterior drawer test result decreased, on average, to 1+, and the Lachman test result decreased to between 0 and 1+. The average Tegner score was 4.6, with five patients returning to their pr einjury level of activity and four returning to one level lower. These results indicate that this is a promising new procedure for patients with instability resulting from lateral ligament injuries of the knee.