Results of use of the central one-third of the patellar ligament to compensate for anterior cruciate ligament deficiency.

In a consecutive series of 91 patients with 92 injured knees in which the anterior cruciate ligament was irrevocably destroyed, 79 were males; 12 were females. After a 7-year interval one male patient had surgery on his other knee. Twenty-five of the knees demonstrated isolated injuries to the anterior cruciate ligament, but the incidence of this lesion may be even greater than recorded here. The anterior cruciate ligament was repaired by a patella ligament reconstruction along with other surgical procedures when indicated. There is no acceptable alternative treatment for surgical repair, or substitution for an acutely torn anterior cruciate ligament in the young patient. In the acute or late injury, if the ligament cannot be repaired with sutures, a substitution procedure is indicated. In 92 knees, including 2 revisions, 9 patients were followed for too short a period to warrant evaluation. In 83 knees, the results were: 59 good; 18 fair; 6 poor. The following 5 surgical complications were encountered: 2 wound infections, 2 poorly placed bone plugs, and one ligament was pinched in the intercondylar notch. Until a more satisfactory technique for substitution for a destroyed anterior cruciate ligament is available, the patellar tendon repair procedure is bound to continue to be a useful as well as relatively simple operation.