[Plastic substitutes for old cruciate ligament ruptures. I. Material, methods, and indications (author's transl)]

A report was made of 101 old cruciate ligament ruptures which were reconstructed at the Orthopedic Hospital in Munich between 1963 and 1975. On the basis of this material, it was confirmed that the anterior ligament is predominantly affected. Injuries of the knee ligaments and, therefore, the cruciate ligaments were acquired by 67 of the 101 patients during the course of sport activity. Football had a particularly high injury quota. Single, isolated cruciate ligament injury was found in 17 cases. Combination injuries with stress on the medial structures of the knee joint were found in 84 cases. 39 cases came to surgery more than 2 years after the accident. In 29 cases, some type of surgery had been carried out previously. The measures used to restore function of the cruciate ligament in addition to tightening the anterior cruciate ligament were Brückner-plasty using the distally flapped medial third of the ligamentum patellae, the free ligamentum-patellae transplant, Augustine-plasty, distally flapped tendoplasty from the pes-anserinus group, Hey-Groves fasciaplasty as well as anterior cruciate ligament-plasty using the ventrally flapped internal meniscus. The necessity of reconstructing additional ligamentous lesions to eliminate complex instabilities was stressed. A plaster fixation is always carried out postoperatively in the lying cast on the thigh. This plaster fixation is completed by restorative measures at the collateral ligaments through a pelvic girdle. Remobilization should begin 6 weeks after the operation. Its length as well as the final result is determined by the condition of the joint before treatment, the technique applied and the postoperative complications.