Witvoët J, Hubert L, Christel P
Service d'Orthopédie et Traumatologie, Hôpital Saint-Louis, Paris.
Rev Chir Orthop Reparatrice Appar Mot. 1987;73(5):325-36.
The authors have studied the results of 91 extra-articular ligamentoplasties amongst 104 knees treated surgically for chronic anterior laxity of the knee. The technique used in 40 cases was a Lemaire isolated lateral extra-articular ligamentoplasty using a strip of fascia lata and in 51 cases a double plasty, combining the same lateral plasty with a tightening of the posteromedial capsule and a forward transfer of the semimembranosus. The follow-up was from one to seven years, with a mean of four years. The results were assessed using the "ARPEGE" (Research Association for the Study of the Knee) scoring system, based on ability to undertake sports, functional stability, pain, resistance to fatigue, mobility and residual laxity. The overall results were excellent in 51 per cent, good in 10 per cent, fair in 10.5 per cent and bad in 28.5 per cent of cases. These results may seem to be unsatisfactory but a detailed study of the failures showed some errors in the indications for surgery which could have been avoided by a full appreciation of the type of laxity, the post-operative needs of the patient, his age and the level of sporting activity. Meniscectomy and lesions of the articular cartilage had a disturbing effect on the results. This study indicates a more precise place for extra-articular ligamentoplasties compared with in situ reconstructions of the anterior cruciate ligament.
