Laboratory and clinical investigations on anterior cruciate reconstruction.

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Using normal cadaver knees from adults, we studied the functional importance of the sites of attachments of the anterior cruciate ligament on the lateral femoral condyle as determinants of the length of the ligament at different amounts of knee flexion. The distance between the central point of the normal attachment area on the tibia and the point slightly proximo-medial to the normal central point on the femur was found to be most isometric with the full range of knee motion. We also studied the biomechanical strength of the two types of the patellar tendon graft (one, a free tendon, and the other, a tendon with its bone insertions at both ends), and found that the bone-tendon preparation achieved stronger fixation to the bone in earlier postoperative time than the free tendon.Between 1981 and 1984, we performed the anterior cruciate reconstruction on 27 patients using the patellar bone-tendon-bone graft. Results were analyzed on 15 patients who were followed for more than one year postoperatively. Eighty per cent of these patients showed excellent or good results. Objective results were better in the patients who had an extra-articular augmentation procedure than in those who had no augmentation.