[Healing of ruptures of the anterior cruciate ligament treated with simple sutures. Possibilities, usefulness, clinical evaluation. Apropos of a series of 51 anterior cruciate ligament sutures using barbed wire with macroscopic verification of the healing].

Fifty-one ruptures of the anterior cruciate ligament were treated by early suture using barbed wires followed by plaster cast for 6 weeks. The state of healing was assessed by a second look during arthrotomy to remove the wire after an average of 6 months. In addition, 45 knees have been examined more than 20 months after the initial repair. Three out of 4 ligaments were found to be healed, but only one out of 3 had adequate tension and was correctly sited. The rate of satisfactory healing was high in cases of clear-cut rupture and when the pre-operative laxity was moderate. Associated lesions of the collateral ligaments healed satisfactorily thanks to the period of 6 weeks treatment in the plaster cast. The cases in which the cruciate ligaments had healed demonstrate subjective and objective stability better than others, even when the ligament had been found to be loose or incorrectly re-implanted and were superior from the functional point of view. There was no parallel between the true state of healing of the ligament and the clinical tests of stability. It is concluded that early suture of the cruciate ligament is worthwhile in cases of clear-cut rupture. In cases of attenuation or when there are severe lesions of the collateral ligaments, suture of the cruciate ligaments should be reinforced by carbon fibres. This management is valuable in active people or amateur sportsmen in whom rehabilitation is somewhat slow. In professional athletes peripheral ligamentoplasties lead to earlier resumption of sporting activities. In older patients, plaster cast immobilisation is sufficient to produce satisfactory results.