[Treatment problems in old and recent rupture of the lateral knee ligament]

The authors have treated 31 fresh ruptures of the lateral ligament and 104 cases of chronic instability of the lateral side of the knee. In recent ruptures the results obtained after surgical repair were not as gratifying as those obtained after injuries of the medial ligament. The cases operated upon were tears of the lateral ligament associated with ruptures of one or both cruciate ligaments. The frequency of rupture of the popliteus tendon is emphasized. The authors recommend, when necessary, a double surgical approach both laterally and posteriorly and plaster cast immobilization for more than 6 weeks. Tendon transfer in recent lesions have been done when suture of a cruciate ligament was impossible. The results of several procedures for chronic instability were analysed; transposition of the patellar ligament, transposition of the head of the fibula, or tightening of the lateral structures of the knee (capsule, ligament, popliteus tendon). Associated lesions of the cruciate ligament were treated by tendon transfer. Poor results were obtained in those presenting with fixed varus deformities. The authors conclude that such deformities should be corrected by osteotomy.