Refixation of femoral anterior cruciate ligament tears combined with a semitendinosus tendon augmentation. Technique and results.

As part of a retrospective study, 76 patients with acute tears of the anterior cruciate ligament who underwent reinsertion and augmentation with the semitendinosus tendon were examined. The follow-up took place on average 4.5 years (range 3-7 years) after surgery. A decreased range of motion upon comparison with the uninjured opposite side was seen in 43 patients. The Lachman test revealed a grade 1 instability in 42 patients, grade 2 in 17 and grade 3 in 2, while 15 patients had a negative test result. The average Lysholm score was 92 points and the Tegner activity score had an average of 7.1 points. KT-1000 measurements showed an identical degree of anterior translation for both knees at 89 N in 25 individuals. The analysis revealed a difference of 2 mm in 15 patients, 4 mm in 19,6 mm in 15 and greater than 6 mm in 2. The radiographic follow-up examination revealed a deterioration of the degenerative change of 1 deg in 17 patients and 2 deg in 4 patients. Isometric testing showed no loss in flexion strength of the operated knee joints compared to the healthy opposite side. The ratio between flexion and extension strength was also identical for both knees. The reinsertion and augmentation with a single strand of semi-tendinosus tendon is not, as this study demonstrates, the appropriate reconstructive technique for the majority of ACL tears.