[Ideal indications for the use of a textile ligament of high strength Trevira in alloplastic replacement of the anterior cruciate ligament in chronic isolated rupture]

Abstract

Between August 1980 and December 1986, 120 patients suffering from chronic instabilities of the knee ligament were submitted to corrective surgery at the Berufsgenossenschaftliche Unfallklinik Frankfurt am Main. A textile ligament made of polyethylene terephthalate (Trevira hochfest type 730) was substituted in all cases for the disturbed or missing ligament structure. 67 out of 100 patients came to the check-up appointments. A precise and objective comparison between the preoperative and postoperative findings of each patient was now possible for the first time thanks to the most recent computer technique. Until now we were not able to do this. Possibly the results published hitherto had a subjective touch and were too much dependent on the feelings of the individual investigators. Full objective stability over several years was reached anyhow in 51.4% of the patients checked up. Especially in case of inveterate isolated rupture of the anterior cruciate ligament, the alloplastic substitution by a ligament made of Trevira hochfest is at present an ideal possibility to restore stability for a long time and to prevent severe secondary wear symptoms of the other interior structures of the knee. The failures and insatisfactory results with respect to stability are explained by an insufficient consideration of the implantation technique recommended. In order to help this method to achieve its welldeserved propagation which would be to the advantage of patients with chronic instabilities of the knee ligament, this technique is explained in detail once more and possible errors are indicated.