Reconstruction of the anterior cruciate ligament by semitendinosus transfer in chronic anterior instability of the knee.

Between 1979 and 1983, 127 chronic anteromedial or anterolateral instabilities of the knee were submitted to surgical treatment (Hughston et al., 1976; Imbert, 1984). The central pivot was reconstructed by the semitendinosus tendon, using our own modification of the original Hughston technique (Puddu et al., 1986). On the medial side we advanced the posterior oblique ligament and reflex tendon of semimembranosus in cases submitted to medial meniscectomy at the same time. Laterally, we always advanced the biceps. As this method produced excellent results very quickly, it was later improved by associating the gracilis tendon with the semitendinosus. Assessment of the results was based on an average follow-up of 5 years (minimum 4, maximum 7). Of the 127 patients we personally interviewed 108 and clinically evaluated 88 professional sportsmen. The results in the latter group were excellent or good in 76.