Secondary reconstruction of anterior cruciate ligament in athletes by using the semitendinosus tendon. Preliminary report of 78 cases.

Secondary reconstruction of the torn anterior cruciate ligament has been accomplished by semitendinosus tenodesis in 78 athletes (average age, 20 years; range, 13 to 45 years old). This series was limited to patients who had isolated tears of the ligament or tears of the anterior cruciate ligament associated with tears of one or both menisci. Meniscectomies were performed in 71 knees and reefing of the posteromedial capsular ligament in 35 knees. After an average of 11 months of follow-up (range, 6 to 29 months postoperatively), 67 (86%) of the patients have obtained significant improvement (0 to 1+ on a scale of 0 to 3+) in anteroposterior and anteromedial rotational instability of the joint. The viability and function of the reconstructed ligament was confirmed by direct visualization in three patients at 12, 25 and 26 months postoperatively. Reefing of the posteromedial capsular ligament appears to increase anteromedial rotation stability. This series will be expanded and the follow-up evaluations will continue over a period of years in an effort to determine whether or not semitendinosus tenodesis is superior to other methods of intraarticular reconstruction for a torn anterior cruciate ligament.