Dynamic reconstruction of the cruciate ligaments of the knee.

This paper reports the long term results of dynamic gracilis or semitendinosus transfer in chronic cruciate ligament instability of the knee. During the period 1968-1983, 76 dynamic reconstructions were performed. Sixty-one patients (63 knees) were evaluated. There were 42 males and 19 females. The mean age at operation was 29.5 years and the average time before operation was 3.7 years. The anterior cruciate ligament was reconstructed in 54 cases, the posterior in 7 and the anterior and posterior in 2. Altogether 32 ligaments (12 cruciates) had been repaired and 28 menisci removed at previous operations. A scoring system (up to 50 points, with 16 parameters) was used. An excellent result was achieved in 21 cases, good in 15, fair in 18 and poor in 19 cases at an average follow-up of 7.4 years. The average score was 33.2 points. Subjectively only 4 patients described the end result as poor. The anterior cruciate alone was reconstructed in 25 patients with an average score of 35.4 points. In 12 cases the operative delay was less than one year and in these the average score was 41.2. In 6 cases three ligaments were reconstructed and the average score was 24.0. There were advanced degenerative changes in 6 knees (average score 24.3).